So maybe one of the best ways to start is to think of this as a little like Skype. ItsLenny uses a protocol like Skype called SIP. You can make calls to each other free online or if you have a paid service you can make calls to a landline and even have your own telephone number.
Once you have a sip account (the e-mail type address) you can use a software client (like skype) or even desk phones that support SIP. From there depending on the phone/software you have, once you receive a call you’d forward that call to lenny (specifically :5060)
A free sip software client that is pretty good - Blink others like Asterisk – Depending on where you live if you wanted to get a land line number you might think about doing a search for SIP DID (Direct Inward Dialing access numbers) and they will give you a SIP account and you can pick out your telephone number.
Hope this helps. Please feel free to chime in if I missed anything.
And because I wanted to start writing about SIP I forgot maybe the simplest method - if you can forward a call from your phone just use the telephone numbers on http://www.itslenny.com/ (they seem to be all down right now).
So far, the only thing that I have found is SIP-Communicator. It support several other protocols, including MSN and XMPP as well.
You can get a free SIP account at SIP2SIP. There they also recommend Blink, but they don't mention that Blink doesn't support video.
I just tried SIP-Communicator with my friend.. it worked pretty well: we could hear each other and he could see my video... although I couldn't see my own video. However, it is still in Alpha (which will probably drive a lot of people away from the get-go... but it looks promising.
I used to use Ekiga for this. Unfortunately I don't know how stable it is, cause it wasn't a use case I needed "24/7" availability. I think it isn't being developed for few years.
There is Blink you might want to try. Haven't tried it myself but they have Linux, MacOS, Win, Android, iOS clients so it might be more suitable for you.
+1 on MicroSIP. I have used MicroSIP with my FreePBX setup at home, no issues. With our Grandstream UCM PBX at work (asterisk based), MicroSIP didn't perform well over the WAN or maybe just not compatible with Grandstream. But Blink worked great across the WAN with Grandstream.
Jitsi (as others have said) is cross platform and pretty good. Jitsi video bridge is phenomenal too... but that's something else.
I use Blink on windows, but I've just realised it does Linux and OSX too.
codecs: opus, G722, speex, gsm, iLBC, PCMU, PCMA. H264 and VP8 video.