Provider Demographics
NPI:1225484736
Name:HALL, LEIGH CALLAWAY (LMFT)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:CALLAWAY
Last Name:HALL
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 1:2224 S CARMELINA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-1024
Mailing Address - Country:US
Mailing Address - Phone:310-876-4914
Mailing Address - Fax:
Practice Address - Street 1:2224 S CARMELINA AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1024
Practice Address - Country:US
Practice Address - Phone:310-876-4914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA118369106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist