Provider Demographics
NPI:1962577791
Name:SMEAL, KEMP LESLIE (MA, MFT)
Entity type:Individual
Prefix:MR
First Name:KEMP
Middle Name:LESLIE
Last Name:SMEAL
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5855 E NAPLES PLZ
Mailing Address - Street 2:109
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803-5060
Mailing Address - Country:US
Mailing Address - Phone:562-485-8599
Mailing Address - Fax:
Practice Address - Street 1:5855 E NAPLES PLZ
Practice Address - Street 2:109
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5060
Practice Address - Country:US
Practice Address - Phone:562-485-8599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC36925106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist