Provider Demographics
NPI:1992373054
Name:DILORENZO - LOHMAN, JAMIE MARISA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:MARISA
Last Name:DILORENZO - LOHMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:DILORENZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2692 KETTERING CT
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5465
Mailing Address - Country:US
Mailing Address - Phone:314-809-7013
Mailing Address - Fax:
Practice Address - Street 1:2692 KETTERING CT
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5465
Practice Address - Country:US
Practice Address - Phone:314-809-7013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20210167471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical