Provider Demographics
NPI:1639536873
Name:LEBLANC, BRANDI LYN (MS, PLPC)
Entity Type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:LYN
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:MS, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 HERBERT RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-7936
Mailing Address - Country:US
Mailing Address - Phone:337-298-5046
Mailing Address - Fax:
Practice Address - Street 1:850 KALISTE SALOOM RD
Practice Address - Street 2:SUITE 219
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4230
Practice Address - Country:US
Practice Address - Phone:337-504-4974
Practice Address - Fax:337-456-2434
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor