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Organization

LORRAINE IBOLD, LCSW COUNSELING

Active
Other names
LORRAINE IBOLD, LCSW COUNSELING SERVICES, INC.
Organization subpart
No

Provider details

NPI number
Authorized official
LORRAINE IBOLD LCSW LCSW (PRESIDENT)
(714) 541-4921
Entity
Organization

Contact information

Practice address
505 N TUSTIN AVE STE 134, SANTA ANA, CA 92705-3712
(714) 541-4921
(714) 541-4925
Mailing address
505 N TUSTIN AVE STE 134, SANTA ANA, CA 92705-3712
(714) 541-4921
(714) 541-4925

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1427079573
AETNA
CA
Enumeration date
04/30/2019
Last updated
06/11/2019
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