Provider Demographics
NPI:1295489581
Name:ACKERMAN, LINDSEY RAE MCOMBER (LMFT)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RAE MCOMBER
Last Name:ACKERMAN
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:PO BOX 341113
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-9113
Mailing Address - Country:US
Mailing Address - Phone:646-533-8638
Mailing Address - Fax:
Practice Address - Street 1:201 HERONDO ST
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-2000
Practice Address - Country:US
Practice Address - Phone:310-993-9853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130278106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist