Provider Demographics
NPI:1588786024
Name:PIKE, LORI HAFNER (LCSW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:HAFNER
Last Name:PIKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANNE
Other - Last Name:HAFNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1220 3RD AVE N
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-1438
Mailing Address - Country:US
Mailing Address - Phone:406-799-1895
Mailing Address - Fax:
Practice Address - Street 1:915 1ST AVE S
Practice Address - Street 2:CENTER FOR MENTAL HEALTH
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3705
Practice Address - Country:US
Practice Address - Phone:406-791-9535
Practice Address - Fax:406-761-2107
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000070106OtherBLUE CROSS-SHIELD OF MONT