Provider Demographics
NPI:1699006817
Name:LEBLANC, JULIE J (LSCSW)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:J
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1832
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-1832
Mailing Address - Country:US
Mailing Address - Phone:620-231-1960
Mailing Address - Fax:620-231-2808
Practice Address - Street 1:101 W SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:KS
Practice Address - Zip Code:66725-1276
Practice Address - Country:US
Practice Address - Phone:620-429-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20100017541041C0700X
KS054481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS110931222OtherMEDICARE
OK200518810AMedicaid
MO497161802Medicaid
KS200876240DMedicaid