Healthcare Provider Details

I. General information

NPI: 1063552123
Provider Name (Legal Business Name): LEE MARILYN O'KEEFE-HARDY MFCC, PSYCH TECH LIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2851 SEABREEZE DR
MALIBU CA
90265-2946
US

IV. Provider business mailing address

2851 SEABREEZE DR
MALIBU CA
90265-2946
US

V. Phone/Fax

Practice location:
  • Phone: 310-456-1554
  • Fax:
Mailing address:
  • Phone: 310-456-1554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberM16513
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: