Provider Demographics
NPI:1679610331
Name:BARTON, LESLIE CHARON (LMFT)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:CHARON
Last Name:BARTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S 6TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-2057
Mailing Address - Country:US
Mailing Address - Phone:805-541-7908
Mailing Address - Fax:805-474-1302
Practice Address - Street 1:150 S 6TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2057
Practice Address - Country:US
Practice Address - Phone:805-541-7908
Practice Address - Fax:805-474-1302
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC34611106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist