Provider Demographics
NPI:1104339118
Name:MOHRING, LORI JEAN (MS, LPC, SAC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:JEAN
Last Name:MOHRING
Suffix:
Gender:F
Credentials:MS, LPC, SAC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:JEAN
Other - Last Name:KITTLESON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, SAC
Mailing Address - Street 1:406 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:WI
Mailing Address - Zip Code:54656-1743
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:420 WI-54
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615
Practice Address - Country:US
Practice Address - Phone:715-284-4301
Practice Address - Fax:715-284-7713
Is Sole Proprietor?:No
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12672-131101YA0400X
WI3072-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)