Provider Demographics
NPI:1649155755
Name:KAUFFMAN, LORI DIANE
Entity type:Individual
Prefix:MISS
First Name:LORI
Middle Name:DIANE
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53065 SHANNON RD
Mailing Address - Street 2:
Mailing Address - City:COLON
Mailing Address - State:MI
Mailing Address - Zip Code:49040-9782
Mailing Address - Country:US
Mailing Address - Phone:269-432-1133
Mailing Address - Fax:
Practice Address - Street 1:53065 SHANNON RD
Practice Address - Street 2:
Practice Address - City:COLON
Practice Address - State:MI
Practice Address - Zip Code:49040-9782
Practice Address - Country:US
Practice Address - Phone:269-432-1133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker