MEDICARE: MS. DARLEEN LORTZ LPC, CRC, 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	61108	TX
2	101YM0800X	Mental Health Counselor	61108	TX
3	101Y00000X	Counselor	61108	TX
4	225C00000X	Rehabilitation Counselor	00072125	TX

General Provider Information

NPI Number	:	1619161056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DARLEEN LORTZ LPC, CRC, NCC

Provider Business Mailing Address
First Line	:	P.O. BOX 1885
Second Line	:
City	:	PILOT POINT
State	:	TX
Zip	:	76258
Country	:	US
Telephone Number	:	817-403-3130
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 S CENTRAL EXPY
Second Line	:	SUITE 200/234
City	:	MCKINNEY
State	:	TX
Zip	:	75070-4070
Country	:	US
Telephone Number	:	817-403-3130
Fax Number	:

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

Provider Enumeration Date	:	08/29/2007
Last Update Date	:	02/17/2015

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