Provider Demographics
NPI:1750837621
Name:LOFSTROM, BETH LUWANDI (LPC)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:LUWANDI
Last Name:LOFSTROM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 CORPORATE PARK DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-3312
Mailing Address - Country:US
Mailing Address - Phone:513-530-5888
Mailing Address - Fax:
Practice Address - Street 1:8150 CORPORATE PARK DR
Practice Address - Street 2:SUITE 170
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-3312
Practice Address - Country:US
Practice Address - Phone:513-530-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC:1400489101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional