Provider Demographics
NPI:1437781978
Name:GERARD, LEIGH H (MA,PLPC)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:H
Last Name:GERARD
Suffix:
Gender:F
Credentials:MA,PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 OAK BEND DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-1436
Mailing Address - Country:US
Mailing Address - Phone:314-852-4159
Mailing Address - Fax:
Practice Address - Street 1:225 S MERAMEC AVE # 721T
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3669
Practice Address - Country:US
Practice Address - Phone:314-474-7252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018044764101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional