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General NPI Number Information
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NPI Number | 1851316608
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Entity Type | Individual
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Provider Name | LESLIE GERARD
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Gender | Female
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 2100 CHARLIE HALL BLVD
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City | CHARLESTON
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State | SC
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Zip | 29414-5832
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Country | US
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Telephone | 336-607-8501
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Fax |
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Provider Business Mailing Address
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Address Line | 1782 BERGENFIELD RD
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City | MOUNT PLEASANT
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State | SC
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Zip | 29466-7101
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Country | US
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Telephone | 336-776-8997
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Fax | 336-725-4030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3181
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License Number State | NC
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