Provider Demographics
NPI:1316598774
Name:FIELDS, LORILYN (LPC)
Entity Type:Individual
Prefix:
First Name:LORILYN
Middle Name:
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 586
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-0586
Mailing Address - Country:US
Mailing Address - Phone:989-340-1466
Mailing Address - Fax:
Practice Address - Street 1:145 S RIPLEY ST STE 2
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-3010
Practice Address - Country:US
Practice Address - Phone:989-565-9600
Practice Address - Fax:989-565-9600
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-26
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401017718101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6401017718OtherPROFESSIONAL COUNSELOR LICENSE