Provider Demographics
NPI:1679793962
Name:SVENDSEN, LORI (BS, CERTIFIED SW)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:SVENDSEN
Suffix:
Gender:F
Credentials:BS, CERTIFIED SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 WAGON DR
Mailing Address - Street 2:
Mailing Address - City:WEST SALEM
Mailing Address - State:WI
Mailing Address - Zip Code:54669-1034
Mailing Address - Country:US
Mailing Address - Phone:608-786-3112
Mailing Address - Fax:
Practice Address - Street 1:14301 COUNTY HIGHWAY B
Practice Address - Street 2:A-19
Practice Address - City:SPARTA
Practice Address - State:WI
Practice Address - Zip Code:54656
Practice Address - Country:US
Practice Address - Phone:608-269-8641
Practice Address - Fax:608-269-8935
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2148132101YA0400X
WI8241201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical