Provider Demographics
NPI:1003200502
Name:BARBER, LESLIE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:
Last Name:BARBER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:PISMO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93448-1327
Mailing Address - Country:US
Mailing Address - Phone:805-904-0393
Mailing Address - Fax:
Practice Address - Street 1:200 S 13TH ST STE 210
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2263
Practice Address - Country:US
Practice Address - Phone:805-904-0393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-23
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85529106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist