Healthcare Provider Details

I. General information

NPI: 1497403729
Provider Name (Legal Business Name): LEIGH BROOKS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2022
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45111 FERN AVE
LANCASTER CA
93534-2301
US

IV. Provider business mailing address

45111 FERN AVE
LANCASTER CA
93534-2301
US

V. Phone/Fax

Practice location:
  • Phone: 661-949-1206
  • Fax: 661-940-5452
Mailing address:
  • Phone: 661-227-7375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC11296
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number16993
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: