MEDICARE: LORI MCGUFFIN

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	44SC00364400	NJ
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1710670799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI MCGUFFIN

Provider Business Mailing Address
First Line	:	3221 ROUTE 38 STE 201
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-9765
Country	:	US
Telephone Number	:	609-251-6947
Fax Number	:

Provider Business Practice Location Address
First Line	:	3221 ROUTE 38 STE 201
Second Line	:
City	:	MOUNT LAUREL
State	:	NJ
Zip	:	08054-9765
Country	:	US
Telephone Number	:	856-437-0441
Fax Number	:

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

Provider Enumeration Date	:	05/26/2023
Last Update Date	:	05/26/2023

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Directions to “ LORI MCGUFFIN ” Practice Location

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