Provider Demographics
NPI:1790553907
Name:LESGOLD, HARRY (MFT)
Entity Type:Individual
Prefix:MR
First Name:HARRY
Middle Name:
Last Name:LESGOLD
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 PIO PICO DR STE 105
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1951
Mailing Address - Country:US
Mailing Address - Phone:760-276-3988
Mailing Address - Fax:
Practice Address - Street 1:3150 PIO PICO DR STE 105
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1951
Practice Address - Country:US
Practice Address - Phone:760-276-3977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT143153106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist