Provider Demographics
NPI:1003698259
Name:SCHELSKE, LORI JO (PHD)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:JO
Last Name:SCHELSKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5356 RADELL DR SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97317-9508
Mailing Address - Country:US
Mailing Address - Phone:503-507-6211
Mailing Address - Fax:
Practice Address - Street 1:1740 SHAFF RD # 233
Practice Address - Street 2:
Practice Address - City:STAYTON
Practice Address - State:OR
Practice Address - Zip Code:97383-1092
Practice Address - Country:US
Practice Address - Phone:503-507-6211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0663106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist