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General NPI Number Information
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NPI Number | 1235388117
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Entity Type | Individual
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Provider Name | ANAMARIA POGACEAN LORSON LPC
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Gender | Female
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 06/22/2016
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Provider Practice Location Address
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Address Line | 300 68TH ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49548-6927
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Country | US
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Telephone | 616-258-7566
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Fax |
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Provider Business Mailing Address
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Address Line | 5120 BROOKWOOD DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49508-4865
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Country | US
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Telephone | 616-551-9399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401011047
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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