Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Leonard Wallace Lane Jr., MFTINTERN

Individual provider Mental Health Counselor · NPI 1770095879

Mr. Leonard Wallace Lane Jr., MFTINTERN is a Mental Health Counselor in Los Angeles, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2017

Practice location Address checks out

1926 Beverly Blvd
Los Angeles, CA 90057-2402
Phone: (213) 353-1140
Fax: (213) 353-1151
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 76583 (CA)

Record details

NPI number1770095879
Entity typeIndividual (Type 1)
GenderMale
Credentials MFTINTERN
Sole proprietorYes
NPI enumeratedOctober 30, 2017
Last updated in NPPESOctober 30, 2017

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