Provider Demographics
NPI:1265940274
Name:FREEMAN, LORI ANN (LPC-IT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 E STATE ST APT 502
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-3248
Mailing Address - Country:US
Mailing Address - Phone:414-840-3117
Mailing Address - Fax:414-444-2435
Practice Address - Street 1:1300 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2602
Practice Address - Country:US
Practice Address - Phone:414-225-1399
Practice Address - Fax:414-225-1346
Is Sole Proprietor?:No
Enumeration Date:2018-01-12
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3795-226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health