Provider Demographics
NPI:1548741002
Name:LECLAIR, ABIGAIL (LICSW)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:LECLAIR
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-1115
Mailing Address - Country:US
Mailing Address - Phone:774-313-8553
Mailing Address - Fax:
Practice Address - Street 1:200 NASHUA ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-1105
Practice Address - Country:US
Practice Address - Phone:617-635-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1188401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical