Provider Demographics
NPI:1376739961
Name:DUKART, LORRETTA ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:LORRETTA
Middle Name:ANN
Last Name:DUKART
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 1:161 HIGH ST SE
Mailing Address - Street 2:SUITE 228
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3660
Mailing Address - Country:US
Mailing Address - Phone:503-588-7644
Mailing Address - Fax:503-588-7833
Practice Address - Street 1:161 HIGH ST SE
Practice Address - Street 2:SUITE 228
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3660
Practice Address - Country:US
Practice Address - Phone:503-588-7644
Practice Address - Fax:503-588-7833
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC0035101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health