Provider Demographics
NPI:1407643109
Name:HAGGARD, LORI (LISW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:HAGGARD
Suffix:
Gender:
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1587 MARCELLA DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-3747
Mailing Address - Country:US
Mailing Address - Phone:513-207-0177
Mailing Address - Fax:
Practice Address - Street 1:1587 MARCELLA DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-3747
Practice Address - Country:US
Practice Address - Phone:513-207-0177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.25065521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical