Provider Demographics
NPI:1932484862
Name:LORRI LIVERS HOUCK, PLLC
Entity Type:Organization
Organization Name:LORRI LIVERS HOUCK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORRI
Authorized Official - Middle Name:LIVERS
Authorized Official - Last Name:HOUCK
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, PMHNP-BC
Authorized Official - Phone:502-275-9898
Mailing Address - Street 1:105 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1525
Mailing Address - Country:US
Mailing Address - Phone:502-897-1999
Mailing Address - Fax:502-896-1004
Practice Address - Street 1:105 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1525
Practice Address - Country:US
Practice Address - Phone:502-897-1999
Practice Address - Fax:502-896-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty