Individual ProviderCrystal LorenzoCounselorBehavioral Health & Social Service ProvidersPractice Address419 E 7th St Ste 207, The Dalles, OR 97058-2676(541) 296-5452PECOS EnrollmentBased on the most recent information from CMS, provider Crystal Lorenzo does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1568996577Provider TypeIndividualFull NameLorenzo, CrystalGenderFemaleSole ProprietorNoEnumeration Date4/17/2017Last Updated4/17/2017Contact InformationPractice LocationPractice Address419 E 7th St Ste 207, The Dalles, OR 97058-2676Phone(541) 296-5452Fax(541) 296-1537Mailing LocationMailing Address419 E 7th St Ste 207, The Dalles, OR 97058-2676Phone(541) 296-5452Fax(541) 296-1537Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID1699745794DescriptionMedicaidIssuerUnlistedOregon