Provider Demographics
NPI:1548594724
Name:LORENZI, TANYA NICOLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:NICOLE
Last Name:LORENZI
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 1:938 KATE DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-5612
Mailing Address - Country:US
Mailing Address - Phone:845-803-0207
Mailing Address - Fax:706-222-4633
Practice Address - Street 1:3925 ROBERTS RD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-2546
Practice Address - Country:US
Practice Address - Phone:706-810-2057
Practice Address - Fax:706-222-4633
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA010808101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health