Provider Demographics
NPI:1811036049
Name:LIGHTFOOT, LEIGHTON CLAIBORNE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LEIGHTON
Middle Name:CLAIBORNE
Last Name:LIGHTFOOT
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 1:2832 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2114
Mailing Address - Country:US
Mailing Address - Phone:707-367-3105
Mailing Address - Fax:510-524-2988
Practice Address - Street 1:2832 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705
Practice Address - Country:US
Practice Address - Phone:707-367-3105
Practice Address - Fax:510-524-2988
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37307106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist