Provider Demographics
NPI:1053080515
Name:HEBERLEY, LORI ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANNE
Last Name:HEBERLEY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 KRESSON RD FL 2
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3228
Mailing Address - Country:US
Mailing Address - Phone:856-429-3494
Mailing Address - Fax:856-229-7683
Practice Address - Street 1:61 KRESSON RD FL 2
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3228
Practice Address - Country:US
Practice Address - Phone:856-429-3494
Practice Address - Fax:856-229-7683
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00025400101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health