Provider Demographics
NPI:1417224155
Name:ALLEN, LORALEA (LPCC-S)
Entity Type:Individual
Prefix:MS
First Name:LORALEA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3862 WILLOW BROOK DR
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-8260
Mailing Address - Country:US
Mailing Address - Phone:330-256-0337
Mailing Address - Fax:
Practice Address - Street 1:135 E ERIE ST STE 304
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-3599
Practice Address - Country:US
Practice Address - Phone:330-256-0337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
OHC 1000353101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health