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LESLIE FOGE MA, MFT
NPI 1003354374
Marriage & Family Therapist in Lafayette, CA

Active since February 07, 2017PECOS Enrolled
954 RISA RD, SUITE A, LAFAYETTE, CA 94549(510) 332-2649 Get Directions Write a Review

NPPES record last updated: February 7, 2017. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Leslie Foge Ma, Mft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LESLIE FOGE MA, MFT (NPI 1003354374) is an individual marriage & family therapist in Lafayette, California, licensed in California (MFT23841) and active in the NPI registry since February 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003354374
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameLESLIE FOGECredential: MA, MFT
Location Address954 RISA RD, SUITE ALafayette, CA 94549-3418
Mailing Address954 Risa Rd, Suite ALafayette, CA 94549-3418 · (510) 332-2649
Phone(510) 332-2649
Sole ProprietorYes
Enumeration DateFebruary 7, 2017
✔ NPI 1003354374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · MFT23841
Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

954 RISA RD, Lafayette, CA 94549
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Leslie Foge Ma, Mft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 24, 2024 through June 24, 2026.

Opt-Out Effective DateJune 24, 2024
Opt-Out In Effect ThroughJune 24, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. AUSTIN GOLLMER HURST PH.D., M.A.
Psychologist (Clinical)
954 RISA RD, SUITE A
LAFAYETTE, CA 94549
Contra Costa County (925) 284-0691
DR. SUSAN MARIE JENNY PH.D.
Psychologist (Clinical)
954 RISA RD, SUITE A
LAFAYETTE, CA 94549
Contra Costa County (925) 284-0685
DR. BRIAN CLARK PSY.D.
Psychologist (Clinical)
954 RISA RD, SUITE A
LAFAYETTE, CA 94549
Contra Costa County (925) 385-8050

Frequently Asked Questions

What is Leslie Foge's NPI number?

The NPI number assigned to this healthcare provider is 1003354374, enumerated as an "individual" on February 07, 2017.

Where is the provider located?

The provider is located at 954 RISA RD SUITE A LAFAYETTE, CA 94549 and the phone number is (510) 332-2649.

What is the provider's specialty?

Marriage & Family Therapist with taxonomy code 106H00000X.