Provider Demographics
NPI:1316579998
Name:BALEK-BEESON, LORRAINE ANN (LPCC)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:ANN
Last Name:BALEK-BEESON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 GARDENIA GLN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-7901
Mailing Address - Country:US
Mailing Address - Phone:760-793-1090
Mailing Address - Fax:
Practice Address - Street 1:REPRODUCTIVE MENTAL HEALTH
Practice Address - Street 2:11838 BERNARDO PLAZA CT #250,
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-9212
Practice Address - Country:US
Practice Address - Phone:858-367-3622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4057101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health