Provider Demographics
NPI:1447642079
Name:BURRELL, LORI DEAN (MA, LSW)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:DEAN
Last Name:BURRELL
Suffix:
Gender:F
Credentials:MA, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 OLD SALEM RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-1094
Mailing Address - Country:US
Mailing Address - Phone:724-837-9540
Mailing Address - Fax:724-837-3676
Practice Address - Street 1:1011 OLD SALEM RD
Practice Address - Street 2:SUITE 202
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1094
Practice Address - Country:US
Practice Address - Phone:724-837-9540
Practice Address - Fax:724-837-3676
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW131167104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker