Provider Demographics
NPI:1942696620
Name:CARNES, JOANNA LEIGH (MFT, LPCC)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:LEIGH
Last Name:CARNES
Suffix:
Gender:F
Credentials:MFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4103
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91359-1103
Mailing Address - Country:US
Mailing Address - Phone:818-425-9487
Mailing Address - Fax:
Practice Address - Street 1:650 HAMPSHIRE RD STE 218
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2546
Practice Address - Country:US
Practice Address - Phone:818-425-9487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC1444101YP2500X
CALMFT45275106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional