Provider Demographics
NPI:1245846518
Name:BETO, LORELEE LYNN (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:LORELEE
Middle Name:LYNN
Last Name:BETO
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:LORELEE
Other - Middle Name:LYNN
Other - Last Name:SLATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24342 JEWEL RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-5668
Mailing Address - Country:US
Mailing Address - Phone:320-360-8553
Mailing Address - Fax:
Practice Address - Street 1:13045 FALCON DR STE 100
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56425-4201
Practice Address - Country:US
Practice Address - Phone:218-828-9307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health