Provider Demographics
NPI:1588546022
Name:GEARHART, LESLEE BETH (PASTORAL COUNSELOR)
Entity type:Individual
Prefix:
First Name:LESLEE
Middle Name:BETH
Last Name:GEARHART
Suffix:
Gender:F
Credentials:PASTORAL COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 S MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:FL
Mailing Address - Zip Code:34736-2731
Mailing Address - Country:US
Mailing Address - Phone:352-429-5600
Mailing Address - Fax:352-429-1206
Practice Address - Street 1:611 S MAIN AVE
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:FL
Practice Address - Zip Code:34736-2731
Practice Address - Country:US
Practice Address - Phone:352-429-5600
Practice Address - Fax:352-429-1206
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLPC0577030225101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral