Provider Demographics
NPI:1699812446
Name:HELLEIS, LESLIE D (LMHC, PHD)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:D
Last Name:HELLEIS
Suffix:
Gender:F
Credentials:LMHC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10441 QUALITY DR STE 303
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-9650
Mailing Address - Country:US
Mailing Address - Phone:352-683-1842
Mailing Address - Fax:352-683-0247
Practice Address - Street 1:10441 QUALITY DR STE 303
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-9650
Practice Address - Country:US
Practice Address - Phone:352-683-1842
Practice Address - Fax:352-683-0247
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0005803101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ0485OtherBLUE CROSS