Individual
STACEY LECLERC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, LCDP
Contact information
Practice address
528 N MAIN ST, PROVIDENCE, RI 02904-5757
(401) 276-4020
Mailing address
528 N MAIN ST UNIT 4, PROVIDENCE, RI 02904-5770
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDP00784
RI
101YM0800X
Mental Health Counselor
Primary
MHC01402
RI
Other
Enumeration date
03/13/2019
Last updated
09/20/2022
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