1245877042 NPI number — LORRIE BOLLARD LPC

Table of content: LORRIE BOLLARD LPC (NPI 1245877042)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245877042 NPI number — LORRIE BOLLARD LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOLLARD
Provider First Name:
LORRIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LPC
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:
1245877042
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 S WALNUT LN STE 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEAVER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15009-1737
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-974-8550
Provider Business Mailing Address Fax Number:
412-774-0893

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 S WALNUT LN STE 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAVER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15009-1737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-974-8550
Provider Business Practice Location Address Fax Number:
412-774-0893
Provider Enumeration Date:
11/30/2019

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: 101YP2500X , with the licence number:  PC006691 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: PC006691 . This is a "PROFESSIONAL COUNSELOR LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com