Individual ProviderLishelle Dawn Youngsma GrantMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address5242 Katella Ave Ste 206, Los Alamitos, CA 90720-2867(562) 231-7356PECOS EnrollmentBased on the most recent information from CMS, provider Lishelle Dawn Youngsma Grant does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1467124636Provider TypeIndividualFull NameYoungsma Grant, Lishelle DawnCredentialLMFTGenderFemaleSole ProprietorYesEnumeration Date10/5/2021Last Updated10/5/2021Contact InformationPractice LocationPractice Address5242 Katella Ave Ste 206, Los Alamitos, CA 90720-2867Phone(562) 231-7356FaxUnlisted FaxMailing LocationMailing Address5242 Katella Ave Ste 206, Los Alamitos, CA 90720-2867Phone(562) 231-7356FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicenseLMFT39490California