MEDICARE: FRANCES MICHELLE LEUCK CAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	ICADC.0000259	FL

General Provider Information

NPI Number	:	1346110236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCES MICHELLE LEUCK CAC

Provider Business Mailing Address
First Line	:	6263 ARLINGTON WAY
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-3127
Country	:	US
Telephone Number	:	772-489-1106
Fax Number	:

Provider Business Practice Location Address
First Line	:	6263 ARLINGTON WAY
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34951-3127
Country	:	US
Telephone Number	:	772-489-1106
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2025
Last Update Date	:	11/06/2025

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