Provider Demographics
NPI:1225549132
Name:DOBSON, LORI (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:DOBSON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:DOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25200 480TH ST
Mailing Address - Street 2:
Mailing Address - City:LAPORTE
Mailing Address - State:MN
Mailing Address - Zip Code:56461-1800
Mailing Address - Country:US
Mailing Address - Phone:218-760-2279
Mailing Address - Fax:
Practice Address - Street 1:1705 ANNE ST NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601
Practice Address - Country:US
Practice Address - Phone:218-333-4559
Practice Address - Fax:218-333-5285
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN185621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical