Provider Demographics
NPI:1497997605
Name:WELSH, LORIE JEAN (PHD, LCPC)
Entity Type:Individual
Prefix:DR
First Name:LORIE
Middle Name:JEAN
Last Name:WELSH
Suffix:
Gender:F
Credentials:PHD, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 MT VERNON RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-7725
Mailing Address - Country:US
Mailing Address - Phone:770-329-2943
Mailing Address - Fax:
Practice Address - Street 1:32 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5624
Practice Address - Country:US
Practice Address - Phone:207-626-3448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005509101YM0800X
MECC3693101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health