Provider Demographics
NPI:1265705875
Name:ALLEN, LORI M (LPC, LMFT)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:M
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 DEVILLE LN # PVT
Mailing Address - Street 2:METHODIST CHILDREN'S HOME FAMILY COUNSEILING CENTER
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-6313
Mailing Address - Country:US
Mailing Address - Phone:318-242-4644
Mailing Address - Fax:318-242-4698
Practice Address - Street 1:902 DEVILLE LN # PVT
Practice Address - Street 2:METHODIST CHILDREN'S HOME FAMILY COUNSEILING CENTER
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-6313
Practice Address - Country:US
Practice Address - Phone:318-242-4644
Practice Address - Fax:318-242-4698
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2934101YM0800X
LA956106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist