Provider Demographics
NPI:1235529082
Name:BUDMAN, LORI J (MSS, LCSW)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:J
Last Name:BUDMAN
Suffix:
Gender:F
Credentials:MSS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 THOMAS AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2607
Mailing Address - Country:US
Mailing Address - Phone:484-442-0491
Mailing Address - Fax:
Practice Address - Street 1:14 THOMAS AVE FL 1
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2607
Practice Address - Country:US
Practice Address - Phone:484-442-0491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1315311041C0700X
PACW02007301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical