Provider Demographics
NPI:1720172521
Name:KHOURY, LEANNE HART (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LEANNE
Middle Name:HART
Last Name:KHOURY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:LEANNE
Other - Middle Name:HART
Other - Last Name:KHOURY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:16152 BEACH BLVD. SUITE 265
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647
Mailing Address - Country:US
Mailing Address - Phone:714-514-3779
Mailing Address - Fax:714-841-3779
Practice Address - Street 1:16152 BEACH BLVD. SUITE 265
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647
Practice Address - Country:US
Practice Address - Phone:714-514-3779
Practice Address - Fax:714-841-3779
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36880106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist