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General NPI Number Information
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NPI Number | 1639310154
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Entity Type | Organization
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Legal Business Name | LEAPS & BOUNDS FAMILY COUNSELING CENTER, INC
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 03/12/2009
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Provider Practice Location Address
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Address Line | 15235 BURBANK BLVD SUITE A3
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City | VAN NUYS
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State | CA
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Zip | 91411-3500
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Country | US
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Telephone | 818-486-3152
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Fax | 818-784-4980
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Provider Business Mailing Address
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Address Line | 15235 BURBANK BLVD SUITE A3
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City | VAN NUYS
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State | CA
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Zip | 91411-3500
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Country | US
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Telephone | 818-486-3152
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Fax | 818-784-4980
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Authorized Official
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Title or Position | CLINICAL DIRECTOR/PRESIDENT
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Name | MS. RENEE ARLA LESTRANGE
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Credential | MFT
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Telephone | 818-486-3152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC36831
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License Number State | CA
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