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General NPI Number Information
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NPI Number | 1356155246
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Entity Type | Organization
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Legal Business Name | LORI IVEY LLC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 127 METRO DR
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City | SPARTANBURG
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State | SC
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Zip | 29303-2789
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Country | US
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Telephone | 864-219-2333
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Fax | 843-589-1242
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Provider Business Mailing Address
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Address Line | PO BOX 926
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City | PACOLET
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State | SC
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Zip | 29372-0926
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Country | US
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Telephone | 864-219-2333
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Fax | 843-589-1242
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | LORI IVEY
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Credential | LPC LCMHC
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Telephone | 864-219-2333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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