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NPI Code Detail

MEDICARE: MRS. LORI N NUEBEL LCSW

MEDICARE: MRS. LORI N NUEBEL LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1073708012
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LORI N NUEBEL LCSW
Provider Business Mailing Address
First Line : 2201 SE LOOP 820
Second Line :
City : FORT WORTH
State : TX
Zip : 76119-5863
Country : US
Telephone Number : 817-730-0328
Fax Number : 817-255-7130
Provider Business Practice Location Address
First Line : 2201 SE LOOP 820
Second Line :
City : FORT WORTH
State : TX
Zip : 76119-5863
Country : US
Telephone Number : 817-730-0328
Fax Number : 817-255-7130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2007
Last Update Date : 06/05/2012

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