Organization Active NPI

Lorraine Ibold, LCSW Counseling

  • Health Service Clinic/Center
  • Santa Ana, CA
National Provider Identifier
1720642192
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
LORRAINE IBOLD, LCSW COUNSELING
Practice address
505 N Tustin Ave Ste 134
Santa Ana, CA 92705-3712
Phone
(714) 541-4921
Fax
(714) 541-4925
NPI assigned
Apr 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lorraine Ibold LCSW, LCSW
Title
President
Phone
(714) 541-4921

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

505 N Tustin Ave Ste 134
Santa Ana, CA 92705-3712

Mailing address

505 N Tustin Ave Ste 134
Santa Ana, CA 92705-3712
Phone (714) 541-4921

Other identifiers 1

IdentifierTypeStateIssuer
1427079573OtherCAAETNA

Other names 1

  • LORRAINE IBOLD, LCSW COUNSELING SERVICES, INC. Doing business as

National Provider Directory

National Provider Directory

Locations

505 N Tustin Ave
Ste 134
Santa Ana, CA 92705
Phone (714) 541-4921

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1720642192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 N TUSTIN AVE STE 134",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053712",
            "telephone_number": "714-541-4921",
            "fax_number": "714-541-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 N TUSTIN AVE STE 134",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053712",
            "telephone_number": "714-541-4921",
            "fax_number": "714-541-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORRAINE IBOLD, LCSW COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "LCSW",
        "authorized_official_first_name": "LORRAINE",
        "authorized_official_middle_name": "IBOLD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-541-4921",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1427079573",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LORRAINE IBOLD, LCSW COUNSELING SERVICES, INC.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LORRAINE IBOLD, LCSW COUNSELING SERVICES, INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.