Provider Demographics
NPI:1649797432
Name:LESSIN, SCOTT ANDREW (LMFT)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:ANDREW
Last Name:LESSIN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2059 SANTO DOMINGO
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-4062
Mailing Address - Country:US
Mailing Address - Phone:805-886-7254
Mailing Address - Fax:
Practice Address - Street 1:500 AIRPORT WAY
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-8500
Practice Address - Country:US
Practice Address - Phone:805-886-7254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA98168106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist