Provider Demographics
NPI:1003261546
Name:WURM, LORNA L (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:L
Last Name:WURM
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 CRAIG ROAD
Mailing Address - Street 2:SUITE 318
Mailing Address - City:ST.LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141
Mailing Address - Country:US
Mailing Address - Phone:314-607-3982
Mailing Address - Fax:
Practice Address - Street 1:655 CRAIG ROAD
Practice Address - Street 2:SUITE 318
Practice Address - City:ST.LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141
Practice Address - Country:US
Practice Address - Phone:314-607-3982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0049081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical