Provider Demographics
NPI:1528781333
Name:LORAH L JOE INC
Entity type:Organization
Organization Name:LORAH L JOE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LORAH
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:JOE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:310-480-5409
Mailing Address - Street 1:1812 W BURBANK BLVD # 228
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1315
Mailing Address - Country:US
Mailing Address - Phone:310-480-5409
Mailing Address - Fax:
Practice Address - Street 1:2600 W OLIVE AVE # 570
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4549
Practice Address - Country:US
Practice Address - Phone:310-480-5409
Practice Address - Fax:310-480-5409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)