Provider Demographics
NPI:1013408624
Name:THAMS, LORRIE ANN (LLPC)
Entity Type:Individual
Prefix:
First Name:LORRIE
Middle Name:ANN
Last Name:THAMS
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:MISS
Other - First Name:LORRIE
Other - Middle Name:ANN
Other - Last Name:VANDEGRIFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5397 MILLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MILLINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48746-8701
Mailing Address - Country:US
Mailing Address - Phone:989-871-9205
Mailing Address - Fax:989-871-3663
Practice Address - Street 1:5397 MILLINGTON RD
Practice Address - Street 2:
Practice Address - City:MILLINGTON
Practice Address - State:MI
Practice Address - Zip Code:48746-8701
Practice Address - Country:US
Practice Address - Phone:989-871-9205
Practice Address - Fax:989-871-3663
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401016274101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional