Provider Demographics
NPI:1720258593
Name:BECK, LOREN B (RAC)
Entity type:Individual
Prefix:
First Name:LOREN
Middle Name:B
Last Name:BECK
Suffix:
Gender:M
Credentials:RAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 PALMETTO RD
Mailing Address - Street 2:
Mailing Address - City:RAYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71269-6415
Mailing Address - Country:US
Mailing Address - Phone:318-728-2970
Mailing Address - Fax:318-728-2272
Practice Address - Street 1:86 PALMETTO RD
Practice Address - Street 2:
Practice Address - City:RAYVILLE
Practice Address - State:LA
Practice Address - Zip Code:71269-6415
Practice Address - Country:US
Practice Address - Phone:318-728-2970
Practice Address - Fax:318-728-2272
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1325101YA0400X, 101YM0800X
LA5035101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health