Provider Demographics
NPI:1598418295
Name:LEBLANC, JOEL C (LADC I)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:C
Last Name:LEBLANC
Suffix:
Gender:M
Credentials:LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HOLMAN ST
Mailing Address - Street 2:
Mailing Address - City:BALDWINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01436-1419
Mailing Address - Country:US
Mailing Address - Phone:978-895-1882
Mailing Address - Fax:
Practice Address - Street 1:90 MADISON ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-2058
Practice Address - Country:US
Practice Address - Phone:774-530-6363
Practice Address - Fax:774-530-6364
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19640101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)