Provider Demographics
NPI:1245487602
Name:BARIL, LORI L (CSAC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:L
Last Name:BARIL
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4104 DRIFTWOOD CT
Mailing Address - Street 2:B107
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-1794
Mailing Address - Country:US
Mailing Address - Phone:623-692-7078
Mailing Address - Fax:920-458-6623
Practice Address - Street 1:2842 S BUSINESS DR
Practice Address - Street 2:B107
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-6518
Practice Address - Country:US
Practice Address - Phone:920-458-6527
Practice Address - Fax:920-458-6623
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI15625-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)