Active NPI
Lori Ann Crosby
- Mental Health Counselor
- Covina, CA
National Provider Identifier
1104135185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMF 64617
- Practice address
- 1126 N Grand Ave
Covina, CA 91724-1551 - Phone
- (626) 967-1667
- Fax
- (626) 967-6027
- NPI assigned
- Sep 24, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Mental Health Counselor | 101YM0800X | IMF 64617 | CA | Primary |
Addresses
Primary practice location
1126 N Grand Ave
Covina, CA 91724-1551
Mailing address
1126 N Grand Ave
Covina, CA 91724-1551
Phone (626) 967-1667
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7439A | Medicaid | CA | |
| 7544 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 64617 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319155200000",
"number": "1104135185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1126 N GRAND AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917241551",
"telephone_number": "626-967-1667",
"fax_number": "626-967-6027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 N GRAND AVE",
"city": "COVINA",
"state": "CA",
"postal_code": "917241551",
"telephone_number": "626-967-1667",
"fax_number": "626-967-6027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROSBY",
"first_name": "LORI",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-24",
"last_updated": "2011-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "IMF 64617",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7439A",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7544",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.