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NPI Code Detail

MEDICARE: MS. MADELEINE LORELEI PSYD, LMFT

MEDICARE: MS. MADELEINE LORELEI PSYD, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TA0400XAddiction (Substance Use Disorder) PsychologistPSY24885CA
2103TA0700XAdult Development & Aging PsychologistPSY24885CA
3103TB0200XCognitive & Behavioral PsychologistPSY24885CA
4103TC1900XCounseling PsychologistPSY24885CA
5103TC2200XClinical Child & Adolescent PsychologistPSY24885CA
6103TF0000XFamily PsychologistPSY24885CA
7103TP2701XGroup Psychotherapy PsychologistPSY24885CA
8106H00000XMarriage & Family TherapistMFC41411CA
9103TC0700XClinical PsychologistPSY24885CA

General Provider Information

NPI Number : 1063586402
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MADELEINE LORELEI PSYD, LMFT
Provider Business Mailing Address
First Line : 785 TUCKER RD
Second Line : SUITE G-PMB # 586
City : TEHACHAPI
State : CA
Zip : 93561-2523
Country : US
Telephone Number : 661-609-9649
Fax Number :
Provider Business Practice Location Address
First Line : 2525 N CHESTER AVE
Second Line :
City : BAKERSFIELD
State : CA
Zip : 93308-1770
Country : US
Telephone Number : 661-609-9649
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2006
Last Update Date : 02/16/2021

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