Provider Demographics
NPI:1881784288
Name:BILODEAU, LORRAINNE ALICE I (LCAS, CCS)
Entity type:Individual
Prefix:MS
First Name:LORRAINNE
Middle Name:ALICE
Last Name:BILODEAU
Suffix:I
Gender:F
Credentials:LCAS, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 WOOD RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-8713
Mailing Address - Country:US
Mailing Address - Phone:910-638-4930
Mailing Address - Fax:910-295-2438
Practice Address - Street 1:145 WOOD RIVER RD
Practice Address - Street 2:
Practice Address - City:WEST END
Practice Address - State:NC
Practice Address - Zip Code:27376-8713
Practice Address - Country:US
Practice Address - Phone:910-638-4930
Practice Address - Fax:910-295-2438
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC243101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6110524Medicaid