Individual provider · Type 1 NPI

Leonard Wallace Lane Jr., MFT INTERN

Mental Health Counselor · Los Angeles, CA

NPI number 1770095879 Active

Practice location

1926 Beverly Blvd
Los Angeles, CA 90057-2402

Call (213) 353-1140 Map

Fax (213) 353-1151

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X76583 (CA)

Mental Health Counselor: Definition to come...

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About NPI 1770095879

Leonard Wallace Lane Jr., MFT INTERN's National Provider Identifier is 1770095879, issued on Oct 30, 2017. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Los Angeles, CA. The record was last updated on Oct 30, 2017.