Provider Demographics
NPI:1235152596
Name:LORTZ, VERONICA CAROL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:VERONICA
Middle Name:CAROL
Last Name:LORTZ
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 1:10035 108TH ST
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-2447
Mailing Address - Country:US
Mailing Address - Phone:727-398-4147
Mailing Address - Fax:727-323-2639
Practice Address - Street 1:3800 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-1237
Practice Address - Country:US
Practice Address - Phone:727-543-6365
Practice Address - Fax:727-323-2639
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 74251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical