Jacob Lorenz, BA, MHP
Counselor, Mental Health in Vienna, IL. Individual provider (NPI-1).
NPI number1164046447
StatusActive
Last updated in NPPESJun 3, 2020
Details
- NPI
- 1164046447
- Entity type
- Individual (NPI-1)
- Name
- Jacob Lorenz
- Credential
- BA, MHP
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 3, 2020
- Certification date
- Jun 3, 2020
- Last updated
- Jun 3, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
101 Oliver StVienna, IL 62995-1660
Phone 618-658-2611 · Fax 618-658-2501
Mailing address
101 Oliver StVienna, IL 62995-1660
Phone 618-658-2611 · Fax 618-658-2501
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