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MISS LEAH LORRAINE DEROSE MFTI
NPI 1477860518
Marriage & Family Therapist in San Luis Obispo, CA

Active since September 10, 2010Opted out of Medicare · through Jan 1, 2028
2178 JOHNSON AVE, SAN LUIS OBISPO, CA 93401(805) 781-1969(805) 788-2197 Get Directions Write a Review

NPPES record last updated: April 15, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Miss Leah Lorraine Derose Mfti NPPES

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

MISS LEAH LORRAINE DEROSE MFTI (NPI 1477860518) is an individual marriage & family therapist in San Luis Obispo, California and active in the NPI registry since September 2010. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1477860518
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameMISS LEAH LORRAINE DEROSECredential: MFTI
Location Address2178 JOHNSON AVESan Luis Obispo, CA 93401-4535
Mailing Address2178 Johnson AveSan Luis Obispo, CA 93401-4535 · (805) 781-1969 · Fax (805) 788-2197
Phone(805) 781-1969
Fax(805) 788-2197
Sole ProprietorNo
Enumeration DateSeptember 10, 2010
Last NPPES UpdateApril 15, 2014
✔ NPI 1477860518 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
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.
2178 JOHNSON AVE, San Luis Obispo, CA 93401
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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

Miss Leah Lorraine Derose Mfti 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 January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

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

CALLIE ROSE BOLLER
Marriage & Family Therapist
2178 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4700
CAMDEN SCHLEISNER
Psychiatric Hospital
2178 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4711
SUSIE JULIANA BAUTISTA
Marriage & Family Therapist
2178 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4960
THOMAS BURDICK
Counselor (Mental Health)
2178 JOHNSON AVE
SAN LUIS OBISBO, CA 93401
San Luis Obispo County (805) 781-4711
KIMBERLY SEAMAN
Counselor (Mental Health)
2178 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4700
JENNIFER N KUIKEN LPT
Licensed Psychiatric Technician
2178 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4712
RONALD ANTHONY VERDUSCO
Nurse's Aide
2178 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4711
RANDY LEE SCHEIDERER PSYCHIATRIC TECH
Licensed Psychiatric Technician
2178 JOHNSON AVE
SAN LUIS OBISPO, CA 93401
San Luis Obispo County (805) 781-4723

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leah Derose's NPI number?

The NPI number for Leah Derose is 1477860518. It was assigned to this individual provider in the NPPES registry on September 10, 2010.

Where is Leah Derose located?

Leah Derose practices at 2178 Johnson Ave, San Luis Obispo, CA 93401. The listed phone number is (805) 781-1969.

What is Leah Derose's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Leah Derose enrolled in Medicare?

No. Leah Derose has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Leah Derose was last updated on April 15, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.