Provider Demographics
NPI:1720409725
Name:LODUCA, LORA (LCPC)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:
Last Name:LODUCA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3089
Mailing Address - Street 2:CENTER FOR MENTAL HEALTH
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-3089
Mailing Address - Country:US
Mailing Address - Phone:406-761-2100
Mailing Address - Fax:406-761-2107
Practice Address - Street 1:4119 7TH AVE N
Practice Address - Street 2:CENTER FOR MENTAL HEALTH/MORNINGSIDE SCHOOL
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-1119
Practice Address - Country:US
Practice Address - Phone:406-761-2100
Practice Address - Fax:406-761-2107
Is Sole Proprietor?:No
Enumeration Date:2013-12-18
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6448101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000749320OtherBLUE CROSS-SHIELD OF MONTANA