1194107367 NPI number — MRS. LORI MARGARET OBERACKER LMHC

Table of content: MRS. LORI MARGARET OBERACKER LMHC (NPI 1194107367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194107367 NPI number — MRS. LORI MARGARET OBERACKER LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OBERACKER
Provider First Name:
LORI
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194107367
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9625 NORTH MILITARY TRAIL
Provider Second Line Business Mailing Address:
COMMUNITY CHRISTIAN COUNSELING CENTER
Provider Business Mailing Address City Name:
PALM BEACH GARDENS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-622-5423
Provider Business Mailing Address Fax Number:
561-636-3592

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9625 NORTH MILITARY TRAIL
Provider Second Line Business Practice Location Address:
COMMUNITY CHRISTIAN COUNSELING CENTER
Provider Business Practice Location Address City Name:
PALM BEACH GARDENS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-622-5423
Provider Business Practice Location Address Fax Number:
561-636-3592
Provider Enumeration Date:
06/24/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  MH12359 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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