MEDICARE: MS. VICTORIA B LORD LMHC

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
1	101YM0800X	Mental Health Counselor	LH00005585	WA

General Provider Information

NPI Number	:	1346465176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICTORIA B LORD LMHC

Provider Business Mailing Address
First Line	:	1200 DUPONT ST
Second Line	:	SUITE 1C
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-3100
Country	:	US
Telephone Number	:	360-756-9696
Fax Number	:	360-647-3693

Provider Business Practice Location Address
First Line	:	1200 DUPONT ST
Second Line	:	SUITE 1C
City	:	BELLINGHAM
State	:	WA
Zip	:	98225-3100
Country	:	US
Telephone Number	:	360-756-9696
Fax Number	:	360-647-3693

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	07/08/2007

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