Provider Demographics
NPI:1477390938
Name:BLANCHARD, KALEIGH (LPC)
Entity type:Individual
Prefix:
First Name:KALEIGH
Middle Name:
Last Name:BLANCHARD
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 1:1205 KINNEY AVE APT L
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-2157
Mailing Address - Country:US
Mailing Address - Phone:231-675-7839
Mailing Address - Fax:
Practice Address - Street 1:1205 KINNEY AVE APT L
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-2157
Practice Address - Country:US
Practice Address - Phone:231-675-7839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86246101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health