Individual
BRIAN KEITH LEBARON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.P.C.
Contact information
Practice address
20 E MILWAUKEE ST, SUITE 210, JANESVILLE, WI 53545-3069
(608) 755-1475
Mailing address
P.O. BOX 247, 413 PRIMROSE LANE, DAVIS, IL 61019-9121
(815) 865-5389
(815) 865-5611
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.006898
IL
101YP2500X
Professional Counselor
178004166
IL
101YP2500X
Professional Counselor
3767-125
WI
Other
Enumeration date
03/28/2007
Last updated
05/12/2008
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