1376363085 NPI number — KENDALL NICOLE LEBLANC LMSW, LCSW-A, CCM

NPI Number: 1376363085
Health Care Provider/Practitioner: KENDALL NICOLE LEBLANC LMSW, LCSW-A, CCM

NPI Number : 1376363085 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376363085",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LEBLANC",
    "FirstName": "KENDALL",
    "MiddleName": "NICOLE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LMSW, LCSW-A, CCM",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5576 GREENVILLE HWY UNIT 24",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ZIRCONIA",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28790-0078",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "713-244-4032",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5576 GREENVILLE HWY UNIT 24",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ZIRCONIA",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28790-0078",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "713-244-4032",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/16/2024",
    "LastUpdateDate": "01/15/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "104100000X",
          "TaxonomyName": "Social Worker",
          "LicenseNumber": "P023362",
          "LicenseNumberStateCode": "NC",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "104100000X",
          "TaxonomyName": "Social Worker",
          "LicenseNumber": "117989",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": "4263368",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}