MEDICARE: STEVEN MARC LESIEUR LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	133664	CA

General Provider Information

NPI Number	:	1306542808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN MARC LESIEUR LMFT

Provider Business Mailing Address
First Line	:	17 CAMBRIA ST APT 2
Second Line	:
City	:	SOMERVILLE
State	:	MA
Zip	:	02143-1501
Country	:	US
Telephone Number	:	657-845-1140
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 S ST ANDREWS PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90018-2042
Country	:	US
Telephone Number	:	657-845-1140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2023
Last Update Date	:	02/06/2023

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