Sephora Lortie, LMHC, LAC, MA
Counselor, Mental Health in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1124544697
StatusActive
Last updated in NPPESApr 17, 2024
Details
- NPI
- 1124544697
- Entity type
- Individual (NPI-1)
- Name
- Sephora Lortie
- Credential
- LMHC, LAC, MA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 16, 2017
- Certification date
- Apr 17, 2024
- Last updated
- Apr 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 39003332A | IN | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 86000377A | IN |
Practice location
535 Airport North Office ParkFort Wayne, IN 46825-6705
Phone 260-619-1603 · Fax 260-818-2121
Mailing address
535 Airport North Office ParkFort Wayne, IN 46825-6705
Phone 260-619-1603 · Fax 260-818-2121
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