Provider Demographics
NPI:1366831638
Name:O'NAN, LORI (BSW, LPCA)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:
Last Name:O'NAN
Suffix:
Gender:F
Credentials:BSW, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 CONSTANZA CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-5335
Mailing Address - Country:US
Mailing Address - Phone:270-855-9407
Mailing Address - Fax:
Practice Address - Street 1:920 FREDERICA ST
Practice Address - Street 2:407
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-3050
Practice Address - Country:US
Practice Address - Phone:270-689-0073
Practice Address - Fax:270-689-0083
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-09
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY128662101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health