Provider Demographics
NPI:1063291284
Name:SATHER, LORI EARLENE (LMSW, CSW INTERN)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:EARLENE
Last Name:SATHER
Suffix:
Gender:F
Credentials:LMSW, CSW INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 W HORIZON RIDGE PKWY APT 2621
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-5539
Mailing Address - Country:US
Mailing Address - Phone:801-201-7007
Mailing Address - Fax:
Practice Address - Street 1:4485 S BUFFALO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-5006
Practice Address - Country:US
Practice Address - Phone:702-900-2169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10983-M104100000X
NVIC-23001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker