Provider Demographics
NPI:1659497212
Name:SMITH, LESLIE JOY (LMFT)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:JOY
Last Name:SMITH
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 1:7624 HOLLISTER AVE UNIT 225
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-2448
Mailing Address - Country:US
Mailing Address - Phone:805-448-7716
Mailing Address - Fax:
Practice Address - Street 1:5385 HOLLISTER AVE BLDG 14
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93111-2389
Practice Address - Country:US
Practice Address - Phone:805-884-1623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79985106H00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist