Individual provider Active NPI

Leslie Gluck, MA, AMFT

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1083231435
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
112715 Issued in CA
Practice address
11835 W Olympic Blvd Ste 815
Los Angeles, CA 90064-5056
Phone
(310) 428-7240
NPI assigned
Jul 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 112715 CA
Marriage & Family Therapist 106H00000X 112715 CA Primary

Addresses

Primary practice location

11835 W Olympic Blvd Ste 815
Los Angeles, CA 90064-5056

Mailing address

155 S Elm Dr Apt 301
Beverly Hills, CA 90212-3321
Phone (310) 486-5881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250530001200 CA Practitioner - Marriage and Family Therapist 3577072776 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Counseling Marriage & Family Therapist CurrentSince Apr 1, 2025 Accepting new patients

Locations

11835 W Olympic Blvd
Ste 815E
Los Angeles, CA 90064
Phone (323) 332-9905

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1083231435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 S ELM DR APT 301",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902123321",
            "telephone_number": "310-486-5881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11835 W OLYMPIC BLVD STE 815",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900645056",
            "telephone_number": "310-428-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLUCK",
        "first_name": "LESLIE",
        "credential": "MA, AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "112715",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "112715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.