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General NPI Number Information
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NPI Number | 1902243835
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Entity Type | Organization
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Legal Business Name | LORI OREND, LCSW LLC
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Dates
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Enumeration Date | 06/01/2013
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Last Update Date | 06/01/2013
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Provider Practice Location Address
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Address Line | 234 MAIN ST
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City | PORTLAND
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State | CT
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Zip | 06480-1861
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Country | US
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Telephone | 860-754-4091
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 701
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City | PORTLAND
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State | CT
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Zip | 06480-0701
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Country | US
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Telephone | 860-754-4091
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Fax |
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | MS. LORI OREND
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Credential | LCSW
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Telephone | 860-754-4091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 4950
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License Number State | CT
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