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General NPI Number Information
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NPI Number | 1932182904
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Entity Type | Individual
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Provider Name | LORI D PINK LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 7500 NW 5TH ST STE 111
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City | PLANTATION
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State | FL
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Zip | 33317-1612
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Country | US
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Telephone | 954-584-6478
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Fax | 954-797-4911
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Provider Business Mailing Address
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Address Line | 950 S PINE ISLAND RD STE 150A
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City | PLANTATION
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State | FL
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Zip | 33324-3918
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Country | US
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Telephone | 954-584-6478
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Fax | 954-797-4911
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW3818
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License Number State | FL
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