Provider Demographics
NPI:1336387570
Name:MESSHAM, LORI (LMHC)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:MESSHAM
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CLEVELAND RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-3813
Mailing Address - Country:US
Mailing Address - Phone:561-252-6613
Mailing Address - Fax:
Practice Address - Street 1:3900 WOODLAKE BLVD STE 200-14
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3044
Practice Address - Country:US
Practice Address - Phone:561-252-6613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5419101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health