Nicole Lederman, ACSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

102930 Issued in CA

Practice address

1603 Granville Ave
Los Angeles, CA 90025-7324

Phone

(917) 539-3658

NPI assigned

Jul 22, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668124800000",
    "number": "1770218786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 GRANVILLE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 GRANVILLE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257324",
            "telephone_number": "917-539-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERMAN",
        "first_name": "NICOLE",
        "credential": "ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-11-11",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "102930",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "102930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luke Nicholas Ledbetter, M.D.
• Hope Ledding, LMFT
• Jessica Leder, DO
• Francine Lederer, PSY.D.
• Matthew Aaron Lederman, M.D.
• Crystal Elizabeth Ledesma
• Daisy Ledesma, R1423660321
• Jeannette Ledesma, RN
• Reegan Joseph Ledet, ASW
• Amancay Ledezma, ASW

• Mental Health Counselor in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.