Provider Demographics
NPI:1538369673
Name:LORANGER, LYNDA LEE (LICSW)
Entity type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:LEE
Last Name:LORANGER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 LONG HWY
Mailing Address - Street 2:
Mailing Address - City:LITTLE COMPTON
Mailing Address - State:RI
Mailing Address - Zip Code:02837-1809
Mailing Address - Country:US
Mailing Address - Phone:401-635-9915
Mailing Address - Fax:508-998-2176
Practice Address - Street 1:10 WELBY RD
Practice Address - Street 2:4364 ACUSHNET AVE
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-1128
Practice Address - Country:US
Practice Address - Phone:508-998-2700
Practice Address - Fax:508-998-2176
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2008-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10313351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP21220OtherMEDICARE