Provider Demographics
NPI:1548709520
Name:STOECKLEIN, LORNA RAE (MS, LPC, LMAC)
Entity type:Individual
Prefix:MS
First Name:LORNA
Middle Name:RAE
Last Name:STOECKLEIN
Suffix:
Gender:F
Credentials:MS, LPC, LMAC
Other - Prefix:MS
Other - First Name:LORNA
Other - Middle Name:RAE
Other - Last Name:STEINERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, LMAC
Mailing Address - Street 1:1337 N MERIDIAN AVENUE SUITE 5,
Mailing Address - Street 2:INDIAN HILLS OFFICE,
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-4641
Mailing Address - Country:US
Mailing Address - Phone:620-200-6255
Mailing Address - Fax:
Practice Address - Street 1:1337 N MERIDIAN AVE STE 5
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4641
Practice Address - Country:US
Practice Address - Phone:620-200-6255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS106101YA0400X
KS2617101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS10Medicaid