Healthcare Provider Details

I. General information

NPI: 1215138300
Provider Name (Legal Business Name): HEATHER LESLIE LINDO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER WILLARD MSW, LCSW, C-ACYFSW

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17350 PROMENADE DR
CLERMONT FL
34711-5948
US

IV. Provider business mailing address

4327 S HWY 27 PMB 203
CLERMONT FL
34711
US

V. Phone/Fax

Practice location:
  • Phone: 704-402-0291
  • Fax:
Mailing address:
  • Phone: 704-706-4528
  • Fax: 704-749-8612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW13438
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSW13438
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: