Provider Demographics
NPI:1629598842
Name:VIEN, LORI (LPCMH, NCC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:VIEN
Suffix:
Gender:F
Credentials:LPCMH, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5618 KIRKWOOD HWY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-5004
Mailing Address - Country:US
Mailing Address - Phone:302-449-7211
Mailing Address - Fax:
Practice Address - Street 1:5618 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5004
Practice Address - Country:US
Practice Address - Phone:302-450-2336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEAC-0000062101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health