Provider Demographics
NPI:1699988287
Name:VAN LITH, LORI M (MED, LMHC)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:M
Last Name:VAN LITH
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 S WENATCHEE AVE STE 124
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2242
Mailing Address - Country:US
Mailing Address - Phone:509-667-7790
Mailing Address - Fax:
Practice Address - Street 1:23 S WENATCHEE AVE STE 124
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2242
Practice Address - Country:US
Practice Address - Phone:509-667-7790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009320101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health