Provider Demographics
NPI:1790509149
Name:VORONIN, LORELEI IRIS (LPC, ATR)
Entity type:Individual
Prefix:
First Name:LORELEI
Middle Name:IRIS
Last Name:VORONIN
Suffix:
Gender:
Credentials:LPC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-9370
Mailing Address - Country:US
Mailing Address - Phone:850-380-3312
Mailing Address - Fax:
Practice Address - Street 1:221 CREEKSIDE DR
Practice Address - Street 2:
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-9370
Practice Address - Country:US
Practice Address - Phone:850-380-3312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81155101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor