Healthcare Provider Details

I. General information

NPI: 1477095982
Provider Name (Legal Business Name): LUCILLE OVERTON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2016
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 E COMPTON BLVD
COMPTON CA
90221-3310
US

IV. Provider business mailing address

1218 E COMPTON BLVD
COMPTON CA
90221-3310
US

V. Phone/Fax

Practice location:
  • Phone: 310-608-1505
  • Fax: 310-627-9065
Mailing address:
  • Phone: 310-608-1505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number152923
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberR38771214
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: