Provider Demographics
NPI:1043632110
Name:LORMAND, DOUGLAS (LPC)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:LORMAND
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 FAWN HVN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1768
Mailing Address - Country:US
Mailing Address - Phone:210-564-5614
Mailing Address - Fax:210-564-5614
Practice Address - Street 1:1407 FAWN HVN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1768
Practice Address - Country:US
Practice Address - Phone:832-364-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-09
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66009101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional