Provider Demographics
NPI:1003228297
Name:LECLAIR, JANESSA CAMELLA
Entity Type:Individual
Prefix:MISS
First Name:JANESSA
Middle Name:CAMELLA
Last Name:LECLAIR
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 1:20 COOKE DR
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1608
Mailing Address - Country:US
Mailing Address - Phone:401-793-1265
Mailing Address - Fax:
Practice Address - Street 1:20 COOKE DR
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1608
Practice Address - Country:US
Practice Address - Phone:401-793-1265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor