Provider Demographics
NPI:1841329851
Name:ELDERKIN, LORI JO (LPC, CADCI)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:JO
Last Name:ELDERKIN
Suffix:
Gender:F
Credentials:LPC, CADCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1706
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-0706
Mailing Address - Country:US
Mailing Address - Phone:541-806-4546
Mailing Address - Fax:541-427-1230
Practice Address - Street 1:708 COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1720
Practice Address - Country:US
Practice Address - Phone:541-806-4546
Practice Address - Fax:888-979-8386
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11-03-47101YA0400X
ORR1946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)