Provider Demographics
NPI:1962623173
Name:STRUYK, LORI LYNN (LSW)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:LYNN
Last Name:STRUYK
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 LAKE FRONT DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-7937
Mailing Address - Country:US
Mailing Address - Phone:513-228-0028
Mailing Address - Fax:
Practice Address - Street 1:551 BATAVIA PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-1518
Practice Address - Country:US
Practice Address - Phone:513-724-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0031693104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker