Healthcare Provider Details

I. General information

NPI: 1437014842
Provider Name (Legal Business Name): LESLIE BETHEA LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 LAVERNE HOLLOW LN UNIT B
HOUSTON TX
77080-1145
US

IV. Provider business mailing address

17022 BANCHORY AVE
SPRING TX
77379-4301
US

V. Phone/Fax

Practice location:
  • Phone: 281-881-0293
  • Fax:
Mailing address:
  • Phone: 281-881-0293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number96921
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: