Provider Demographics
NPI:1518229269
Name:GREGOIRE, LEANNE KAY (MSW/LSW)
Entity Type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:KAY
Last Name:GREGOIRE
Suffix:
Gender:F
Credentials:MSW/LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 N SCHUYLER AVE
Mailing Address - Street 2:
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-3833
Mailing Address - Country:US
Mailing Address - Phone:815-933-7791
Mailing Address - Fax:815-933-4601
Practice Address - Street 1:270 N SCHUYLER AVE
Practice Address - Street 2:
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-3833
Practice Address - Country:US
Practice Address - Phone:815-933-7791
Practice Address - Fax:815-933-4601
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150010983104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker