Chad Thomas Lorenz, PSY.D., MBA
Individual provider Active NPI Family Psychologist · Victoria, MN
NPI 1629213541 · NPPES record last updated May 23, 2016
Key facts
- NPI
- 1629213541
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Psychologist 103TF0000X
- License
- LP 5754 (MN)
- Practice address
- 1772 Steiger Lake LN Ste 220
Victoria, MN 55386-7723 - Phone
- (952) 443-4600
- Fax
- (952) 443-4604
- NPI assigned
- Dec 5, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160830000196 | MN | Practitioner - Clinical Psychologist | 2264727296 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Business Administration
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP 5754 | MN | MD | Family Psychologist |
Interoperability endpoints
- chad.lorenz.1@16506.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Psychologist | 103TF0000X | LP 5754 | MN | Yes |
| Marriage & Family Therapist | 106H00000X | 1764 | MN |
Addresses
Primary practice location
1772 Steiger Lake LN Ste 220
Victoria, MN 55386-7723
Mailing address
PO Box 51
Victoria, MN 55386
Phone (952) 443-4600
Other providers in Victoria, MN
- Allison Klos
- Arsalan Kouser
- Stephanie Ellen Laurey
- Chanel Shanni Lopez
- Lorenz Clinic, LLC
- Ashley Elizabeth Luehrs
- Gregory Scott Marchetti
- Christina McGraw
- Linda Louise McKoskey
- Noah James Meffert
All providers in Victoria, MN · Family Psychologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 23, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.