Provider Demographics
NPI:1083285308
Name:LOHMAN, LARA ALEXANDRA (LCSW)
Entity Type:Individual
Prefix:
First Name:LARA
Middle Name:ALEXANDRA
Last Name:LOHMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 WYNDHAM LN
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3129
Mailing Address - Country:US
Mailing Address - Phone:469-759-9050
Mailing Address - Fax:541-237-1662
Practice Address - Street 1:2909 WYNDHAM LN
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-3129
Practice Address - Country:US
Practice Address - Phone:469-759-9050
Practice Address - Fax:541-237-1662
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
GACSW0073451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical