Provider Demographics
NPI:1609289818
Name:SPURLING, LORA (LSW)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:
Last Name:SPURLING
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4434 SECOR RD STE 2
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4265
Mailing Address - Country:US
Mailing Address - Phone:419-206-1192
Mailing Address - Fax:419-407-5439
Practice Address - Street 1:4434 SECOR RD STE 2
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4265
Practice Address - Country:US
Practice Address - Phone:419-206-1192
Practice Address - Fax:419-407-5439
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-05
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.17004171041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0234583Medicaid