1710022934 NPI number — MRS. LAUREN ELIZABETH LEISING LMFT

Table of content: MRS. LAUREN ELIZABETH LEISING LMFT (NPI 1710022934)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710022934 NPI number — MRS. LAUREN ELIZABETH LEISING LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEISING
Provider First Name:
LAUREN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KRAMLICH
Provider Other First Name:
LAUREN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1710022934
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6410 SOUTHWEST BLVD
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
BENBROOK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76109-3914
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-846-8012
Provider Business Mailing Address Fax Number:
817-370-1068

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6410 SOUTHWEST BLVD
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
BENBROOK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76109-3914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-846-8012
Provider Business Practice Location Address Fax Number:
817-370-1068
Provider Enumeration Date:
02/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com