Provider Demographics
NPI:1376127977
Name:MERRIAM-LEBLANC, CARRIE ANN (MPA)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:ANN
Last Name:MERRIAM-LEBLANC
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:MRS
Other - First Name:CARRIE
Other - Middle Name:
Other - Last Name:LEBLANC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPA
Mailing Address - Street 1:30 TANAGERS LNDG
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-4769
Mailing Address - Country:US
Mailing Address - Phone:508-380-8499
Mailing Address - Fax:
Practice Address - Street 1:107 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2499
Practice Address - Country:US
Practice Address - Phone:866-493-4187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor