Provider Demographics
NPI:1891869939
Name:MOZENA, LORI A (LMFT)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:A
Last Name:MOZENA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 33RD ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-4011
Mailing Address - Country:US
Mailing Address - Phone:515-224-0337
Mailing Address - Fax:
Practice Address - Street 1:1201 63RD ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50311-1943
Practice Address - Country:US
Practice Address - Phone:515-254-1556
Practice Address - Fax:515-254-1559
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical