| Lori Ivey Llc | |
|
127 Metro Dr Spartanburg SC 29303-2789 | |
| (864) 219-2333 | |
| (843) 589-1242 |
| Full Name | Lori Ivey Llc |
|---|---|
| Speciality | Counselor |
| Location | 127 Metro Dr, Spartanburg, South Carolina |
| Authorized Official Name and Position | Lori Ivey (OWNER/PROVIDER) |
| Authorized Official Contact | 8642192333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lori Ivey Llc Po Box 926 Pacolet SC 29372-0926 Ph: (864) 219-2333 | Lori Ivey Llc 127 Metro Dr Spartanburg SC 29303-2789 Ph: (864) 219-2333 |
| NPI Number | 1356155246 |
|---|---|
| Provider Enumeration Date | 02/03/2025 |
| Last Update Date | 02/03/2025 |
| Certification Date | 02/03/2025 |
| Medicare PECOS PAC ID | 5294265674 |
|---|---|
| Medicare Enrollment ID | O20250214000848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356155246 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Lori Ann Ivey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518477520 PECOS PAC ID: 6103356589 Enrollment ID: I20250214000962 |
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