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General NPI Number Information
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NPI Number | 1376363085
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Entity Type | Individual
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Provider Name | KENDALL NICOLE LEBLANC LMSW, LCSW-A, CCM
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Gender | Female
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Dates
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Enumeration Date | 10/16/2024
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 5576 GREENVILLE HWY UNIT 24
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City | ZIRCONIA
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State | NC
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Zip | 28790-0078
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Country | US
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Telephone | 713-244-4032
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Fax |
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Provider Business Mailing Address
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Address Line | 5576 GREENVILLE HWY UNIT 24
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City | ZIRCONIA
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State | NC
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Zip | 28790-0078
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Country | US
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Telephone | 713-244-4032
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | P023362
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 117989
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 4263368
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License Number State | TX
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