Provider Demographics
NPI:1396051405
Name:LEBARRON, THERESE ANN (LCPC)
Entity type:Individual
Prefix:MS
First Name:THERESE
Middle Name:ANN
Last Name:LEBARRON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 E POTOMAC ST
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21795-1169
Mailing Address - Country:US
Mailing Address - Phone:443-386-6544
Mailing Address - Fax:888-386-4048
Practice Address - Street 1:119 E POTOMAC ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:MD
Practice Address - Zip Code:21795-1169
Practice Address - Country:US
Practice Address - Phone:443-386-6544
Practice Address - Fax:888-386-4048
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3625101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional