Provider Demographics
NPI:1801219266
Name:LORI A DRITZ LCSW PC
Entity Type:Organization
Organization Name:LORI A DRITZ LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:DRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:845-452-4030
Mailing Address - Street 1:3 CLEVELAND DR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-6001
Mailing Address - Country:US
Mailing Address - Phone:845-452-4030
Mailing Address - Fax:877-224-9708
Practice Address - Street 1:11 MARSHALL RD
Practice Address - Street 2:SUITE 2L
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4132
Practice Address - Country:US
Practice Address - Phone:845-452-4030
Practice Address - Fax:877-224-9708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR031263-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty