Provider Demographics
NPI:1154661049
Name:GEARHART, ELIZABETH DARLENE
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DARLENE
Last Name:GEARHART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6002
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37320-6002
Mailing Address - Country:US
Mailing Address - Phone:423-284-8156
Mailing Address - Fax:
Practice Address - Street 1:4026 TOMAHAWK CIR NW
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-3466
Practice Address - Country:US
Practice Address - Phone:423-284-8156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist