Provider Demographics
NPI:1639310154
Name:LEAPS & BOUNDS FAMILY COUNSELING CENTER, INC
Entity Type:Organization
Organization Name:LEAPS & BOUNDS FAMILY COUNSELING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:ARLA
Authorized Official - Last Name:LESTRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:818-486-3152
Mailing Address - Street 1:15235 BURBANK BLVD
Mailing Address - Street 2:SUITE A3
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-3500
Mailing Address - Country:US
Mailing Address - Phone:818-486-3152
Mailing Address - Fax:818-784-4980
Practice Address - Street 1:15235 BURBANK BLVD
Practice Address - Street 2:SUITE A3
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-3500
Practice Address - Country:US
Practice Address - Phone:818-486-3152
Practice Address - Fax:818-784-4980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36831106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1841361961OtherNPI NUMBER- INDIVIDUAL PROVIDER