Provider Demographics
NPI:1508246679
Name:STANGL, LORI ANN (LSW)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:STANGL
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 N 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-6513
Mailing Address - Country:US
Mailing Address - Phone:814-934-2398
Mailing Address - Fax:
Practice Address - Street 1:615 HOWARD AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4813
Practice Address - Country:US
Practice Address - Phone:814-934-2398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW131202104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker