Provider Demographics
NPI:1548224926
Name:FITCH, LORI ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:FITCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:WYNNE
Other - Suffix:V
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:411 1/2 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-2486
Mailing Address - Country:US
Mailing Address - Phone:570-476-6460
Mailing Address - Fax:570-476-6466
Practice Address - Street 1:411 1/2 MAIN ST
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-2486
Practice Address - Country:US
Practice Address - Phone:570-476-6460
Practice Address - Fax:570-476-6466
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003866101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional