Provider Demographics
NPI:1497001978
Name:HALVORSON, LORI (LMHC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:HALVORSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:SCHOH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:515 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-1958
Mailing Address - Country:US
Mailing Address - Phone:641-990-4936
Mailing Address - Fax:641-842-4912
Practice Address - Street 1:515 6TH AVE
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-1958
Practice Address - Country:US
Practice Address - Phone:641-990-6955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001591101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health