Provider Demographics
NPI:1669204434
Name:DUBOSE, LAMONT LEE (AMFT, CADC I)
Entity type:Individual
Prefix:MR
First Name:LAMONT
Middle Name:LEE
Last Name:DUBOSE
Suffix:
Gender:M
Credentials:AMFT, CADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 ARLINGTON AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90018-1300
Mailing Address - Country:US
Mailing Address - Phone:323-334-9000
Mailing Address - Fax:
Practice Address - Street 1:1447 16TH ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2715
Practice Address - Country:US
Practice Address - Phone:310-828-6717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA158589106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist