Active NPI
Lorena Borella-Clements, LMFT
- Marriage & Family Therapist
- Mount Shasta, CA
National Provider Identifier
1508188293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 84543
- Practice address
- 419 Chestnut St Apt 2
Mount Shasta, CA 96067-2918 - Phone
- (530) 859-5054
- NPI assigned
- Feb 22, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 84543 | CA | Primary |
Addresses
Primary practice location
419 Chestnut St Apt 2
Mount Shasta, CA 96067-2918
Mailing address
PO Box 856
Mount Shasta, CA 96067-0856
Phone (530) 859-5054
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 84543 | CA | MD | Clinical Social Worker |
Interoperability endpoints
- lifestancehealth.lorenaborellaclements@148835.advancedmd-direct.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438214400000",
"number": "1508188293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 856",
"city": "MOUNT SHASTA",
"state": "CA",
"postal_code": "960670856",
"telephone_number": "530-859-5054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 CHESTNUT ST APT 2",
"city": "MOUNT SHASTA",
"state": "CA",
"postal_code": "960672918",
"telephone_number": "530-859-5054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORELLA-CLEMENTS",
"first_name": "LORENA",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-22",
"last_updated": "2015-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "84543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Shasta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.