Provider Demographics
NPI:1568664456
Name:RILEY, LORREE GATCH (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LORREE
Middle Name:GATCH
Last Name:RILEY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 RIVIERE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-4266
Mailing Address - Country:US
Mailing Address - Phone:704-364-9680
Mailing Address - Fax:
Practice Address - Street 1:5614 RIVIERE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-4266
Practice Address - Country:US
Practice Address - Phone:704-364-9680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4502101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional