MEDICARE: MS. LYNDA LEE LORANGER LICSW

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	1041C0700X	Clinical Social Worker	1031335	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P21220	OTHER	MA	MEDICARE

General Provider Information

NPI Number	:	1538369673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LYNDA LEE LORANGER LICSW

Provider Business Mailing Address
First Line	:	64 LONG HWY
Second Line	:
City	:	LITTLE COMPTON
State	:	RI
Zip	:	02837-1809
Country	:	US
Telephone Number	:	401-635-9915
Fax Number	:	508-998-2176

Provider Business Practice Location Address
First Line	:	10 WELBY RD
Second Line	:	4364 ACUSHNET AVE
City	:	NEW BEDFORD
State	:	MA
Zip	:	02745-1128
Country	:	US
Telephone Number	:	508-998-2700
Fax Number	:	508-998-2176

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

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	07/12/2008

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