Provider Demographics
NPI:1164585139
Name:RANGER-JOHNSON, LORNA M (LCSW)
Entity Type:Individual
Prefix:
First Name:LORNA
Middle Name:M
Last Name:RANGER-JOHNSON
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 1:1200 BROWN ST
Mailing Address - Street 2:4TH FLOOR - CREDENTIALING
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-3617
Mailing Address - Country:US
Mailing Address - Phone:914-734-8858
Mailing Address - Fax:914-734-8786
Practice Address - Street 1:1037 MAIN ST
Practice Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2913
Practice Address - Country:US
Practice Address - Phone:914-734-8800
Practice Address - Fax:845-765-9406
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0467561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00473038Medicaid
NYA400075185Medicare PIN