Provider Demographics
NPI:1568505055
Name:LEBLANC, DENNIS E (D MIN,LMFT)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:E
Last Name:LEBLANC
Suffix:
Gender:M
Credentials:D MIN,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-2525
Mailing Address - Country:US
Mailing Address - Phone:413-773-3484
Mailing Address - Fax:
Practice Address - Street 1:116 FEDERAL ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2525
Practice Address - Country:US
Practice Address - Phone:413-773-3484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA425106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist