STACEY LECLERC (NPI# 1346709029) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346709029 |
| Entity Type | Individual |
| Full Name | STACEY LECLERC |
| Credential | BS, LCDP |
| Practice Address |
528 N Main St Providence RI 02904-5757 |
| Mailing Address |
528 N Main St Unit 4 Providence RI 02904-5770 |
| Practice Telephone | 4012764020 |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2019-03-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
CDP00784 | RI | Behavioral Health & Social Service Providers |
| Street Address |
528 N MAIN ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02904-5757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881683985 | Arnold Harvey Herman | Surgery | 528 N Main St, Suite 3, Providence, RI 02904-5762 | 2005-10-20 |
| 1881220630 | John Vincent Gambino | Registered Nurse | 528 N Main St, Providence, RI 02904-5757 | 2020-03-12 |
| 1316506157 | Fallon Ellen Perreault | Counselor | 528 N Main St, Providence, RI 02904-5757 | 2019-06-06 |
| 1801358643 | Jora Ehrlich | Counselor | 528 N Main St, Providence, RI 02904-5757 | 2019-04-02 |
| 1235625294 | Scott David Robinson | Registered Nurse | 528 N Main St, Providence, RI 02904-5757 | 2018-07-02 |
| 1548754484 | Rachel Armada | Social Worker | 528 N Main St, Providence, RI 02904-5770 | 2018-06-14 |
| 1801399449 | Gail Marie Moran | Registered Nurse | 528 N Main St, Providence, RI 02904-5757 | 2018-03-09 |
| 1255830816 | Vanessa Madrid | Registered Nurse | 528 N Main St, Providence, RI 02904-5757 | 2018-02-08 |
| 1619498664 | Shauna Mccafferty | Social Worker | 528 N Main St, Providence, RI 02904-5757 | 2017-06-29 |
| 1265969463 | Kristina Carlson | Counselor | 528 N Main St, Providence, RI 02904-5757 | 2017-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144792383 | Lifespan Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 180 Corliss Street, Suite A, Providence, RI 02904 | 2018-12-28 |
| 1780168229 | Beth M. Kalunian | Social Worker | 480 Charles Street, Providence, RI 02904 | 2018-09-20 |
| 1588161608 | Michael P. Johnson, Md, Inc | Internal Medicine | 148 W River St Ste 22b, Providence, RI 02904 | 2018-04-06 |
| 1780045948 | Fred Saccoccio | Pharmacist | 15 Smithfield Road, No Providence, RI 02904 | 2016-03-16 |
| 1699148999 | Latin Adult Day Health Care Center | Clinic/Center | 665 Charles Street, Providence, RI 02904 | 2015-11-09 |
| 1144639956 | Dina P Toolin | Occupational Therapist | 195 Collyer St. 3rd Floor, University Medical Center/miriam Hospital Outpatient, Providence, RI 02904 | 2014-08-06 |
| 1801208798 | Seth Clark | Internal Medicine | 200 Corliss St, Providence, RI 02904 | 2014-05-27 |
| 1134554645 | Molly Elizabeth Smith | Physical Therapist | 1405 Douglas Ave, North Providence, RI 02904 | 2013-09-04 |
| 1336408723 | Emad Awa | Pediatrics | 1 Randall Sq Ste 404, Providence, RI 02904 | 2012-05-07 |
| 1598036790 | Joseph F. Osmanski, Od, Inc | Optometrist | 1971 Mineral Spring Avenue, N. Providence, RI 02904 | 2012-01-19 |
| Find all providers in zip 02904 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477100808 | Raisa Emilia Garcia-diaz | Counselor | 66 Pavilion Avenue, Providence, RI 02905 | 2019-08-21 |
| 1952873317 | Better Care Transport LLC | Counselor | 448 Public St, Providence, RI 02907-1223 | 2018-12-26 |
| 1407234172 | David Lee Russell Jr. | Counselor | 60 Comstock Ave, Providence, RI 02907-1206 | 2015-05-13 |
| 1558755082 | Souad Cheteyan | Counselor | 315 Mount Pleasant Ave, Providence, RI 02908-3836 | 2015-03-23 |
| 1588081533 | Nicole Ann Hutto | Counselor | 20 Vandieman Ave, Providence, RI 02909-5560 | 2014-03-27 |
| 1396050597 | Daniel D Strother | Counselor | 66 Pavilion Ave., Providence, RI 02905 | 2010-08-11 |
| 1902137748 | Lux Maria Taylor | Counselor | 662 Hartford Ave, Providence, RI 02909-5917 | 2010-01-19 |
| 1780805283 | Marcel A Trisvan | Counselor | Codac Providence, 349 Huntington Ave, Providence, RI 02909 | 2007-05-01 |
| 1316063829 | Digna Marrero | Counselor | 16 Borinquen St, 662 Hartford Ave., Providence, RI 02905-3202 | 2007-03-22 |
| 1467554634 | George Edward Benedict | Counselor | Providence Vamc, 830 Chalkstone Avenue, Providence, RI 02908-4799 | 2006-09-01 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02904 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.