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NPI Code Detail

MEDICARE: LESLIE WORTH LMFT

MEDICARE:   LESLIE  WORTH  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistMT3834FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114445103
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE WORTH LMFT
Provider Business Mailing Address
First Line : PO BOX 1659
Second Line :
City : EUSTIS
State : FL
Zip : 32727-1659
Country : US
Telephone Number : 352-217-4316
Fax Number :
Provider Business Practice Location Address
First Line : 851 N DONNELLY ST STE 11
Second Line :
City : MOUNT DORA
State : FL
Zip : 32757-4835
Country : US
Telephone Number : 352-217-4316
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2017
Last Update Date : 09/06/2023

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Directions to “ LESLIE WORTH LMFT” Practice Location

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