Provider Demographics
NPI:1922190453
Name:LORENC, CAMERON R (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:CAMERON
Middle Name:R
Last Name:LORENC
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12990 ROCKBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3683
Mailing Address - Country:US
Mailing Address - Phone:719-594-9607
Mailing Address - Fax:
Practice Address - Street 1:487 WINDCHIME PL
Practice Address - Street 2:SUITE 300
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-1933
Practice Address - Country:US
Practice Address - Phone:719-594-9607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO536106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist