Provider Demographics
NPI:1912482985
Name:LORI NELSEN LUNEBURG, PHD, PLLC
Entity Type:Organization
Organization Name:LORI NELSEN LUNEBURG, PHD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NELSEN LUNEBURG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:610-960-5340
Mailing Address - Street 1:50 W WELSH POOL RD
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1200
Mailing Address - Country:US
Mailing Address - Phone:610-960-5340
Mailing Address - Fax:
Practice Address - Street 1:50 W WELSH POOL RD
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-1200
Practice Address - Country:US
Practice Address - Phone:610-960-5340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty