Provider Demographics
NPI:1699348284
Name:LORENZO, OSBURT JOHN (MSW)
Entity type:Individual
Prefix:
First Name:OSBURT
Middle Name:JOHN
Last Name:LORENZO
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 CARRIAGE DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-2368
Mailing Address - Country:US
Mailing Address - Phone:907-830-3337
Mailing Address - Fax:
Practice Address - Street 1:2912 CARRIAGE DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-2368
Practice Address - Country:US
Practice Address - Phone:907-830-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health