Provider Demographics
NPI:1962827352
Name:WARHOLAK, LORI ANN (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:WARHOLAK
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3716 MARINER ST
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-2269
Mailing Address - Country:US
Mailing Address - Phone:248-408-0929
Mailing Address - Fax:
Practice Address - Street 1:837 S LAPEER RD STE 205
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-5084
Practice Address - Country:US
Practice Address - Phone:248-891-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-21
Last Update Date:2021-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802064882171M00000X
MI6401017982101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator