Provider Demographics
NPI:1578813895
Name:DREYER, LORI MARIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:MARIE
Last Name:DREYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4302 ORRINE ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-4480
Mailing Address - Country:US
Mailing Address - Phone:573-673-6312
Mailing Address - Fax:573-874-3189
Practice Address - Street 1:201 N GARTH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-4105
Practice Address - Country:US
Practice Address - Phone:573-449-3953
Practice Address - Fax:573-874-3189
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120309331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical