Provider Demographics
NPI:1780478438
Name:KURRELL, LORIE (LCSW CAADC)
Entity type:Individual
Prefix:MRS
First Name:LORIE
Middle Name:
Last Name:KURRELL
Suffix:
Gender:
Credentials:LCSW CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4042 ROUTE 204
Mailing Address - Street 2:
Mailing Address - City:SELINSGROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17870-8789
Mailing Address - Country:US
Mailing Address - Phone:570-975-5595
Mailing Address - Fax:
Practice Address - Street 1:4042 ROUTE 204
Practice Address - Street 2:
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870-8789
Practice Address - Country:US
Practice Address - Phone:570-975-5595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA16149101YA0400X
PACW0247531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)