Provider Demographics
NPI:1952599417
Name:LEBLANC, SARAH (LICSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E WASHINGTON ST UNIT 64
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-6324
Mailing Address - Country:US
Mailing Address - Phone:508-500-1482
Mailing Address - Fax:508-213-3785
Practice Address - Street 1:500 E WASHINGTON ST UNIT 64
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-6324
Practice Address - Country:US
Practice Address - Phone:508-500-1482
Practice Address - Fax:508-213-3785
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1159981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1309161Medicaid