Provider Demographics
NPI:1831331859
Name:LECLAIRE, NANCY JO (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JO
Last Name:LECLAIRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2256 WINTER WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1955
Mailing Address - Country:US
Mailing Address - Phone:407-740-5655
Mailing Address - Fax:407-740-0372
Practice Address - Street 1:2256 WINTER WOODS BLVD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-1955
Practice Address - Country:US
Practice Address - Phone:407-740-5655
Practice Address - Fax:407-740-0372
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical