Provider Demographics
NPI:1932842903
Name:LEBLANG, JOSHUA M (LMHC, LCPC)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:M
Last Name:LEBLANG
Suffix:
Gender:M
Credentials:LMHC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2348 N 58TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5946
Mailing Address - Country:US
Mailing Address - Phone:510-326-8730
Mailing Address - Fax:
Practice Address - Street 1:2348 N 58TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5946
Practice Address - Country:US
Practice Address - Phone:510-326-8730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-18
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-952101YP2500X
WALH00009678101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional