Provider Demographics
NPI:1578660106
Name:KIEFER, LORI E (LPC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:E
Last Name:KIEFER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:E
Other - Last Name:KIEFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:8772 BIG BEND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-3730
Mailing Address - Country:US
Mailing Address - Phone:314-962-7788
Mailing Address - Fax:314-962-4158
Practice Address - Street 1:8772 BIG BEND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-3730
Practice Address - Country:US
Practice Address - Phone:314-962-7788
Practice Address - Fax:314-962-4158
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001015120101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO177209OtherBCBS
MO214567OtherCOMPYSCH
MO7632437OtherAETNA
MO286901OtherMANAGED HEALTH NETWORK
MO455823OtherVALUE OPTIONS
MO634064OtherHEALTHLINK