Provider Demographics
NPI:1710071659
Name:O'RENICK, LAWRENCE (LPC)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:
Last Name:O'RENICK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 NW SOUTH 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64015
Mailing Address - Country:US
Mailing Address - Phone:816-804-2839
Mailing Address - Fax:816-224-6243
Practice Address - Street 1:1080 NW SOUTH OUTER RD
Practice Address - Street 2:SUITE 202
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64015-3064
Practice Address - Country:US
Practice Address - Phone:816-228-5335
Practice Address - Fax:816-228-7663
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000358101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO29570011OtherBLUE CROSS BLUE SHIELD