Basic Information
| Provider Information | |||||||||
| NPI: | 1295100253 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEBLANC | ||||||||
| FirstName: | HOLLY | ||||||||
| MiddleName: | |||||||||
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| Credential: | LCSWA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 E MEETING ST | ||||||||
| Address2: | |||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286553593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284373000 | ||||||||
| FaxNumber: | 8284374999 | ||||||||
| Practice Location | |||||||||
| Address1: | 276 E CHESTNUT ST | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288012036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284373000 | ||||||||
| FaxNumber: | 8284374999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2015 | ||||||||
| LastUpdateDate: | 01/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | C011272 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 101YA0400X | 20801 | NC | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
ID Information
| ID | Type | State | Issuer | Description | 20801 | 01 | NC | LICENSE # | OTHER | C011272 | 01 | NC | LICENSE SW | OTHER |