Provider Demographics
NPI:1528197761
Name:LEACH, LORNE WINIFRED (LMFT, CADC-II)
Entity Type:Individual
Prefix:MS
First Name:LORNE
Middle Name:WINIFRED
Last Name:LEACH
Suffix:
Gender:F
Credentials:LMFT, CADC-II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5450 S SLAUSON AVE UNIT 116
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6062
Mailing Address - Country:US
Mailing Address - Phone:310-397-0810
Mailing Address - Fax:
Practice Address - Street 1:6838 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90028
Practice Address - Country:US
Practice Address - Phone:323-461-3161
Practice Address - Fax:323-461-5683
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2018-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA3737496101YA0400X
CAMFC 37168106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)