Provider Demographics
NPI:1750483293
Name:SECCHIAROLI, LORI R (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:R
Last Name:SECCHIAROLI
Suffix:
Gender:F
Credentials:LCSW
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 405
Mailing Address - Street 2:
Mailing Address - City:NORTH STONINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06359-0405
Mailing Address - Country:US
Mailing Address - Phone:860-460-1442
Mailing Address - Fax:
Practice Address - Street 1:391 NORWICH WESTERLY RD
Practice Address - Street 2:UNIT 3D - BOX 405
Practice Address - City:NORTH STONINGTON
Practice Address - State:CT
Practice Address - Zip Code:06359-9998
Practice Address - Country:US
Practice Address - Phone:860-460-1442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical