Provider Demographics
NPI:1952443103
Name:FLOR, LOIS JUNE (MA LICSW)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:JUNE
Last Name:FLOR
Suffix:
Gender:F
Credentials:MA LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 287
Mailing Address - Street 2:521 BROADWAY AVENUE NORTH
Mailing Address - City:BRAHAM
Mailing Address - State:MN
Mailing Address - Zip Code:55006
Mailing Address - Country:US
Mailing Address - Phone:320-396-3333
Mailing Address - Fax:320-396-3363
Practice Address - Street 1:521 BROADWAY AVENUE NORTH
Practice Address - Street 2:FIVE COUNTY MENTAL HEALTH CENTER BRAHAM
Practice Address - City:BRAHAM
Practice Address - State:MN
Practice Address - Zip Code:55006
Practice Address - Country:US
Practice Address - Phone:320-396-3333
Practice Address - Fax:320-396-3363
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7571104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
44323OtherOPTUM
HP23951OtherHEALTHPARTNERS
05Q72FLOtherBCBS
1012838OtherPREFERRED ONE
6246041OtherUBH
P00033243OtherRAILROAD MEDICARE