Provider Demographics
NPI:1194448050
Name:FREELOVE, LORENA LYNN (LCSW)
Entity type:Individual
Prefix:MS
First Name:LORENA
Middle Name:LYNN
Last Name:FREELOVE
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 1:1117 N MAIN ST APT 3
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-6839
Mailing Address - Country:US
Mailing Address - Phone:435-557-2488
Mailing Address - Fax:
Practice Address - Street 1:1117 N MAIN ST APT 3
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-6839
Practice Address - Country:US
Practice Address - Phone:435-557-2488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11731060-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical