Provider Demographics
NPI:1164752333
Name:CAO, LORI R (LAMFT)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:R
Last Name:CAO
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3903 MORNINGSIDE RD
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5024
Mailing Address - Country:US
Mailing Address - Phone:952-261-8468
Mailing Address - Fax:
Practice Address - Street 1:804 LAKE ST E
Practice Address - Street 2:SUITE 204
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-1980
Practice Address - Country:US
Practice Address - Phone:952-261-8468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2064106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist