Provider Demographics
NPI:1811009673
Name:LENAHAN, CAROLEE MARGARET (MFT)
Entity Type:Individual
Prefix:
First Name:CAROLEE
Middle Name:MARGARET
Last Name:LENAHAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 PRIMROSE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4037
Mailing Address - Country:US
Mailing Address - Phone:650-579-4993
Mailing Address - Fax:650-340-9093
Practice Address - Street 1:329 PRIMROSE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4037
Practice Address - Country:US
Practice Address - Phone:650-579-4993
Practice Address - Fax:650-340-9093
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC16415101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ87824ZOtherBLUE SHIELD