Provider Demographics
NPI:1134403967
Name:MCGUIRE, LORI ANN (MSSA, LISW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:MSSA, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 LONDON AVE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-5512
Mailing Address - Country:US
Mailing Address - Phone:937-578-7792
Mailing Address - Fax:937-578-2467
Practice Address - Street 1:17853 STATE ROUTE 31 STE B
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-8835
Practice Address - Country:US
Practice Address - Phone:937-578-4004
Practice Address - Fax:937-578-4024
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI13034971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical