MEDICARE: MS. LORI VANESSA ANDREWS LPC

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	1742	OK

General Provider Information

NPI Number	:	1497738769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORI VANESSA ANDREWS LPC

Provider Business Mailing Address
First Line	:	PO BOX 84
Second Line	:
City	:	SEMINOLE
State	:	OK
Zip	:	74818-0084
Country	:	US
Telephone Number	:	405-382-2890
Fax Number	:	405-382-0078

Provider Business Practice Location Address
First Line	:	400 TIMMONS ST
Second Line	:
City	:	SEMINOLE
State	:	OK
Zip	:	74868-3163
Country	:	US
Telephone Number	:	405-382-2890
Fax Number	:	405-382-0078

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

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	05/09/2019

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