Healthcare Provider Details

I. General information

NPI: 1659497212
Provider Name (Legal Business Name): LESLIE JOY SMITH LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5385 HOLLISTER AVE BLDG 14
SANTA BARBARA CA
93111-2389
US

IV. Provider business mailing address

7624 HOLLISTER AVE UNIT 225
GOLETA CA
93117-2448
US

V. Phone/Fax

Practice location:
  • Phone: 805-884-1623
  • Fax:
Mailing address:
  • Phone: 805-448-7716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number79985
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: