Provider Demographics
NPI:1104990811
Name:MUNROE, LORENZO JOHN (LCSW)
Entity type:Individual
Prefix:MR
First Name:LORENZO
Middle Name:JOHN
Last Name:MUNROE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 W MAIN ST
Mailing Address - Street 2:SUITE 106E
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-4501
Mailing Address - Country:US
Mailing Address - Phone:203-363-0560
Mailing Address - Fax:888-548-6611
Practice Address - Street 1:2001 W MAIN ST
Practice Address - Street 2:SUITE 106E
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-4501
Practice Address - Country:US
Practice Address - Phone:203-363-0560
Practice Address - Fax:888-548-6611
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0039821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical