Provider Demographics
NPI:1730680083
Name:EARHART, LORI JEAN (MA)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:JEAN
Last Name:EARHART
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:MAMMOTH
Mailing Address - State:PA
Mailing Address - Zip Code:15664-0073
Mailing Address - Country:US
Mailing Address - Phone:724-417-2665
Mailing Address - Fax:724-219-3697
Practice Address - Street 1:766 E PITTSBURGH ST STE 101
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2678
Practice Address - Country:US
Practice Address - Phone:412-246-8965
Practice Address - Fax:724-219-3697
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)