Healthcare Provider Details

I. General information

NPI: 1881568764
Provider Name (Legal Business Name): LESA GEARHEART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 3025
YOUNGSTOWN OH
44511-0025
US

IV. Provider business mailing address

PO BOX 3025
YOUNGSTOWN OH
44511-0025
US

V. Phone/Fax

Practice location:
  • Phone: 330-759-3040
  • Fax:
Mailing address:
  • Phone: 330-759-3040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC-2507416-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: