Healthcare Provider Details

I. General information

NPI: 1083285308
Provider Name (Legal Business Name): LARA ALEXANDRA LOHMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2021
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1372 CHARNELTON ST APT A
EUGENE OR
97401-3905
US

IV. Provider business mailing address

2909 WYNDHAM LN
RICHARDSON TX
75082-3129
US

V. Phone/Fax

Practice location:
  • Phone: 469-759-9050
  • Fax: 541-237-1662
Mailing address:
  • Phone: 469-759-9050
  • Fax: 541-237-1662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW007345
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09925642
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL7303
License Number StateOR
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number105722
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: