Provider Demographics
NPI:1821733924
Name:LEBOEUF, BRANDON (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:LEBOEUF
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 E LANCASTER AVE STE 2C
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2719
Mailing Address - Country:US
Mailing Address - Phone:484-237-1853
Mailing Address - Fax:484-237-1426
Practice Address - Street 1:721 E LANCASTER AVE STE 2C
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2719
Practice Address - Country:US
Practice Address - Phone:484-237-1853
Practice Address - Fax:484-237-1426
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0226701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical