Healthcare Provider Details

I. General information

NPI: 1700717857
Provider Name (Legal Business Name): NATALIE LEBLANC MASTERS COUNSELOR ED
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 420656
KISSIMMEE FL
34742-0656
US

IV. Provider business mailing address

PO BOX 420656
KISSIMMEE FL
34742-0656
US

V. Phone/Fax

Practice location:
  • Phone: 800-630-1002
  • Fax: 407-674-2510
Mailing address:
  • Phone: 800-630-1002
  • Fax: 407-674-2510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number820634
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number29214
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: