Provider Demographics
NPI:1093366965
Name:BRAHMS, LEEOR G (LMFT)
Entity Type:Individual
Prefix:
First Name:LEEOR
Middle Name:G
Last Name:BRAHMS
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 1:2699 1/2 N BEACHWOOD DR # 4140
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-2339
Mailing Address - Country:US
Mailing Address - Phone:323-250-3141
Mailing Address - Fax:
Practice Address - Street 1:2699 1/2 N BEACHWOOD DR # 4140
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-2339
Practice Address - Country:US
Practice Address - Phone:323-250-3141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA131633106H00000X
CA113548106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-2633765OtherMEDI-CAL