Healthcare Provider Details

I. General information

NPI: 1720734262
Provider Name (Legal Business Name): ADENA LORENA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2022
Last Update Date: 08/04/2023
Certification Date: 08/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 W FORK RD BLDG 2
CINCINNATI OH
45211-1944
US

IV. Provider business mailing address

1394 CROTTY CT APT 2
CINCINNATI OH
45255-3056
US

V. Phone/Fax

Practice location:
  • Phone: 513-586-1257
  • Fax:
Mailing address:
  • Phone: 513-546-2099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC.2305104
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: