Individual provider Active NPI

Lori I Lauridsen, MA, LMHC

  • Mental Health Counselor
  • Casselberry, FL
National Provider Identifier
1104030048
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH9753 Issued in FL
Practice address
661 Seminola Blvd
Casselberry, FL 32707-3057
Phone
(407) 678-6655
Fax
(407) 696-6999
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH9753 FL Primary

Addresses

Primary practice location

661 Seminola Blvd
Casselberry, FL 32707-3057

Mailing address

822 Rill Dr
Altamonte Springs, FL 32714-7524
Phone (407) 435-5013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MH9753FLMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1104030048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 RILL DR",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327147524",
            "telephone_number": "407-435-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 SEMINOLA BLVD",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327073057",
            "telephone_number": "407-678-6655",
            "fax_number": "407-696-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAURIDSEN",
        "first_name": "LORI",
        "middle_name": "I",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH9753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casselberry, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.