Provider Demographics
NPI:1770768806
Name:PLATER, LORI FORD (LCSW-C)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:FORD
Last Name:PLATER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:SUZANNE
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:3 GREENWOOD PL
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-2762
Mailing Address - Country:US
Mailing Address - Phone:410-602-0153
Mailing Address - Fax:410-602-8492
Practice Address - Street 1:3 GREENWOOD PL
Practice Address - Street 2:SUITE 106
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-2762
Practice Address - Country:US
Practice Address - Phone:410-602-0153
Practice Address - Fax:410-602-8492
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD128881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDJ6710001OtherBLUE CROSS BLUE SHIELD
MD409235000Medicaid
MD707ARLOtherBLUE CROSS BLUE SHIELD
MDJ6710001OtherBLUE CROSS BLUE SHIELD
MD222P493GMedicare UPIN