Provider Demographics
NPI:1982105961
Name:LOFTUS, MEGHAN (LPCC)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:LOFTUS
Suffix:
Gender:
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3815
Mailing Address - Country:US
Mailing Address - Phone:818-325-7843
Mailing Address - Fax:
Practice Address - Street 1:20401 VICTOR ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-2297
Practice Address - Country:US
Practice Address - Phone:310-533-4299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00001824106S00000X
CA16371101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician