Provider Demographics
NPI:1811974744
Name:D'AMORE, LOREN (MSW/LISW)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:
Last Name:D'AMORE
Suffix:
Gender:M
Credentials:MSW/LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8577 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-2345
Mailing Address - Country:US
Mailing Address - Phone:330-393-4370
Mailing Address - Fax:
Practice Address - Street 1:8577 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-2345
Practice Address - Country:US
Practice Address - Phone:330-393-4370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI - 00023071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW23941Medicare PIN
OHSW23942Medicare PIN