| Lori A Park, MS,LCSW | |
|
415 W Baseline Spur Rd, Globe, AZ 85501 | |
| (928) 402-9297 | |
| (928) 402-9414 |
| Full Name | Lori A Park |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 22 Years |
| Location | 415 W Baseline Spur Rd, Globe, Arizona |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053561431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-12565 (Arizona) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Community Bridges Inc | 2062699721 | 106 |
| Entity Name | Horizon Health and Wellness, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1659308989 PECOS PAC ID: 6406759711 Enrollment ID: O20040202000450 |
| Entity Name | Little Colorado Behavioral Health Center Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1134292485 PECOS PAC ID: 4587657465 Enrollment ID: O20040406001303 |
| Entity Name | Community Bridges Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558095315 PECOS PAC ID: 2062699721 Enrollment ID: O20110606000388 |
| Mailing Address | Practice Location Address |
|---|---|
| Lori A Park, MS,LCSW 415 W Baseline Spur Rd, Globe, AZ 85501 Ph: (928) 402-9297 | Lori A Park, MS,LCSW 415 W Baseline Spur Rd, Globe, AZ 85501 Ph: (928) 402-9297 |
Lisa Ann Allison, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5860 S Hospital Dr, Globe, AZ 85501 Phone: 928-402-0491 Fax: 928-402-0490 |