Provider Demographics
NPI:1245524685
Name:LABRECQUE, LEANNE
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:LABRECQUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 CONGRESS ST
Mailing Address - Street 2:336
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 CONGRESS ST
Practice Address - Street 2:SUITE 336
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4002
Practice Address - Country:US
Practice Address - Phone:508-843-7219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health