Provider Demographics
NPI:1912242371
Name:WORLINE, LORI J (MED)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:J
Last Name:WORLINE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 W SOUTH BOUNDARY ST BLDG 7B
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-5244
Mailing Address - Country:US
Mailing Address - Phone:419-724-4233
Mailing Address - Fax:877-622-7635
Practice Address - Street 1:900 W SOUTH BOUNDARY ST BLDG 7B
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5244
Practice Address - Country:US
Practice Address - Phone:419-724-4233
Practice Address - Fax:877-622-7635
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0900098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC0900098OtherSTATE OF OHIO COUNSELOR AND SOCIAL WORKER BOARD, MARRIAGE & FAMILY THERAPIST BD