Healthcare Provider Details

I. General information

NPI: 1225464589
Provider Name (Legal Business Name): MR. MICHAEL LEMLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2013
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 DALY ST
LINCOLN HEIGHTS CA
90031-2230
US

IV. Provider business mailing address

2309 DALY ST
LINCOLN HEIGHTS CA
90031-2230
US

V. Phone/Fax

Practice location:
  • Phone: 323-222-4591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number85831
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: