Provider Demographics
NPI:1902243835
Name:LORI OREND, LCSW LLC
Entity Type:Organization
Organization Name:LORI OREND, LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:OREND
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-754-4091
Mailing Address - Street 1:PO BOX 701
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06480-0701
Mailing Address - Country:US
Mailing Address - Phone:860-754-4091
Mailing Address - Fax:
Practice Address - Street 1:234 MAIN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:CT
Practice Address - Zip Code:06480-1861
Practice Address - Country:US
Practice Address - Phone:860-754-4091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-01
Last Update Date:2013-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4950261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health