Provider Demographics
NPI:1245877042
Name:BOLLARD, LORRIE (LPC)
Entity type:Individual
Prefix:
First Name:LORRIE
Middle Name:
Last Name:BOLLARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S WALNUT LN STE 201
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-1737
Mailing Address - Country:US
Mailing Address - Phone:412-974-8550
Mailing Address - Fax:412-774-0893
Practice Address - Street 1:300 S WALNUT LN STE 201
Practice Address - Street 2:
Practice Address - City:BEAVER
Practice Address - State:PA
Practice Address - Zip Code:15009-1737
Practice Address - Country:US
Practice Address - Phone:412-974-8550
Practice Address - Fax:412-774-0893
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-30
Last Update Date:2019-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006691101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC006691OtherPROFESSIONAL COUNSELOR LICENSE