Organization
LORRAINE IBOLD, LCSW COUNSELING
Active
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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