| Organization Name: | LOREN E. NOVAK & ASSOCIATES, INC. |
| NPI Number: | 1417037060 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM M. WALBERG (EXECUTIVE DIRECTOR) |
| Mailing Address: | 14162 Commerce Ave Ne Suite 400 Prior Lake |
| State: | MN US |
| Postal Code: | 553721480 |
| Phone Number: | 9524471117 |
| Fax Number: | 9524471116 |
| NPI Enumeration Date: | 10/17/2006 |
| NPI Last Update Date: | 07/10/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 810953-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |