Provider Demographics
NPI:1477327021
Name:LABUDA, LEILY (LMFT 141864)
Entity Type:Individual
Prefix:
First Name:LEILY
Middle Name:
Last Name:LABUDA
Suffix:
Gender:F
Credentials:LMFT 141864
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8416 LOOKOUT MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-1551
Mailing Address - Country:US
Mailing Address - Phone:323-791-1976
Mailing Address - Fax:
Practice Address - Street 1:8416 LOOKOUT MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90046-1551
Practice Address - Country:US
Practice Address - Phone:323-791-1976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA141864106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist