Individual
MS. LORI KAY CUNNINGTON ELAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1355 W 13TH AVE, EUGENE, OR 97402-3955
(541) 206-2718
(541) 606-3607
Mailing address
PO BOX 1045, VENETA, OR 97487-1045
(541) 206-2718
(541) 636-3607
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L4837
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L4837
OREGON STATE BOARD OF LICENSED SOCIAL WORKERS
OR
Enumeration date
03/16/2007
Last updated
03/18/2014
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