Provider Demographics
NPI:1083707509
Name:SALSBURY, LORI MARIE
Entity Type:Individual
Prefix:MISS
First Name:LORI
Middle Name:MARIE
Last Name:SALSBURY
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:NELSON-SALSBURY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:6900 UNIVERSITY AVENUE
Mailing Address - Street 2:SUITE 135
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50311-1505
Mailing Address - Country:US
Mailing Address - Phone:515-243-1020
Mailing Address - Fax:515-883-1946
Practice Address - Street 1:6900 UNIVERSITY AVENUE
Practice Address - Street 2:SUITE 135
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50311-1505
Practice Address - Country:US
Practice Address - Phone:515-243-1020
Practice Address - Fax:515-883-1946
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05408104100000X
IA00454101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA242275OtherMIDLANDS CHOICE