Provider Demographics
NPI:1134366040
Name:LORENZ, MICHELE MARIE (MSW, LCSW)
Entity type:Individual
Prefix:MISS
First Name:MICHELE
Middle Name:MARIE
Last Name:LORENZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 WARNER AVE.
Mailing Address - Street 2:SUITE 208
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649
Mailing Address - Country:US
Mailing Address - Phone:714-274-9573
Mailing Address - Fax:714-274-9654
Practice Address - Street 1:5200 WARNER AVE.
Practice Address - Street 2:SUITE 208
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649
Practice Address - Country:US
Practice Address - Phone:714-274-9573
Practice Address - Fax:714-274-9654
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-14
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0050001041C0700X
CALCS283921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical