Provider Demographics
NPI:1447842646
Name:LORENZEN, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:LORENZEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 N BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-3208
Mailing Address - Country:US
Mailing Address - Phone:479-339-5018
Mailing Address - Fax:
Practice Address - Street 1:280 S LEWIS AVE APT 4
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-5498
Practice Address - Country:US
Practice Address - Phone:479-339-5018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23534101YM0800X
RIMHC01767101YM0800X
ARA2011167101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health