Provider Demographics
NPI:1922042126
Name:GREER, LORI N (PSYD)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:N
Last Name:GREER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:N
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:6010 SADDLE RIDGE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:WI
Mailing Address - Zip Code:53901
Mailing Address - Country:US
Mailing Address - Phone:608-745-4309
Mailing Address - Fax:608-742-3641
Practice Address - Street 1:2639 NEW PINERY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:PORTAGE
Practice Address - State:WI
Practice Address - Zip Code:53901-1110
Practice Address - Country:US
Practice Address - Phone:608-742-5020
Practice Address - Fax:608-742-3641
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI13515OtherDEAN INSURANCE
WI39130900Medicaid