MEDICARE: LORETTA KAY PICKFORD LPC, NCC

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	101YP2500X	Professional Counselor	6401013887	MI

General Provider Information

NPI Number	:	1376973065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORETTA KAY PICKFORD LPC, NCC

Provider Business Mailing Address
First Line	:	4101 W FOREST RD
Second Line	:
City	:	LAKE CITY
State	:	MI
Zip	:	49651-9710
Country	:	US
Telephone Number	:	231-434-8587
Fax Number	:	844-206-0063

Provider Business Practice Location Address
First Line	:	4101 W FOREST RD
Second Line	:
City	:	LAKE CITY
State	:	MI
Zip	:	49651-9710
Country	:	US
Telephone Number	:	231-434-8587
Fax Number	:

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

Provider Enumeration Date	:	11/18/2013
Last Update Date	:	09/26/2023

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