Provider Demographics
NPI:1679807283
Name:CASPER, LORI A (MA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:CASPER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E 27TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-3203
Mailing Address - Country:US
Mailing Address - Phone:970-669-2370
Mailing Address - Fax:970-669-2790
Practice Address - Street 1:345 E 27TH ST
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3203
Practice Address - Country:US
Practice Address - Phone:970-669-2370
Practice Address - Fax:970-669-2790
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO580106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist