Active NPI
Lorraine Ibold, LCSW Counseling
- Health Service Clinic/Center
- Santa Ana, CA
National Provider Identifier
1720642192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427079573 | Other | CA | AETNA |
Other names 1
- LORRAINE IBOLD, LCSW COUNSELING SERVICES, INC.
National Provider Directory
National Provider DirectoryLocations
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.
-
- Clinical Social Worker
- Santa Ana, CA
- NPI 1427079573
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.