Provider Demographics
NPI:1598308637
Name:PENDLETON, LORA MARION (LCSWA)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:MARION
Last Name:PENDLETON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 ELKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WOODFIN
Mailing Address - State:NC
Mailing Address - Zip Code:28804-3102
Mailing Address - Country:US
Mailing Address - Phone:828-582-1900
Mailing Address - Fax:
Practice Address - Street 1:1314 PATTON AVE STE F
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2648
Practice Address - Country:US
Practice Address - Phone:828-225-3100
Practice Address - Fax:828-225-3604
Is Sole Proprietor?:No
Enumeration Date:2019-10-22
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0141061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical