Basic Information
| Provider Information | |||||||||
| NPI: | 1366576357 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOFGREN | ||||||||
| FirstName: | WARD | ||||||||
| MiddleName: | AARON | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MS, LPC, CADCI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1795 COURT ST NE | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973014327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5039495956 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1675 WINTER ST NE | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973037152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035850351 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | C1970 | OR | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.