Provider Demographics
NPI:1760002679
Name:LEBLANC, LORY R (LPC)
Entity Type:Individual
Prefix:
First Name:LORY
Middle Name:R
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 MARSH LN APT 1414
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-4866
Mailing Address - Country:US
Mailing Address - Phone:409-789-3542
Mailing Address - Fax:
Practice Address - Street 1:1820 PRESTON PARK BLVD STE 2200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3614
Practice Address - Country:US
Practice Address - Phone:214-561-6185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-21
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79808101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional