Provider Demographics
NPI:1932344934
Name:AUSTIN, LORA J (LSW)
Entity Type:Individual
Prefix:MRS
First Name:LORA
Middle Name:J
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:J
Other - Last Name:SAHERHWAITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:212 N. BARRON ST
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320-1704
Mailing Address - Country:US
Mailing Address - Phone:937-438-9500
Mailing Address - Fax:937-886-5694
Practice Address - Street 1:212 N. BARRON ST
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-1704
Practice Address - Country:US
Practice Address - Phone:937-438-9500
Practice Address - Fax:574-406-7311
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5-00163591041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
14660728OtherCAQH
OH0393740Medicaid