Provider Demographics
NPI:1619129459
Name:PETERS, LORRIE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:LORRIE
Middle Name:ANN
Last Name:PETERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5256 E TRINDLE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-3548
Mailing Address - Country:US
Mailing Address - Phone:717-319-0317
Mailing Address - Fax:717-918-1034
Practice Address - Street 1:5256 E TRINDLE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-3548
Practice Address - Country:US
Practice Address - Phone:717-319-0317
Practice Address - Fax:717-918-1034
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0171661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical