Individual provider Active NPI

Danyelle Leblanc

  • Mental Health Counselor
  • Brockton, MA
National Provider Identifier
1124619291
Registry record updated Feb 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
104 Torrey St
Brockton, MA 02301-4855
Phone
(508) 427-4383
NPI assigned
Feb 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MA
Mental Health Counselor 101YM0800X LMHC10002583 MA
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X MA Primary

Addresses

Primary practice location

104 Torrey St
Brockton, MA 02301-4855

Mailing address

891 Montello St
Brockton, MA 02301-6657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMHC10002583MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Old Colony Young Men'S Christian Association, Inc. Multi-Specialty CurrentSince Feb 1, 2021 Accepting new patients

Locations

891 Montello St
Brockton, MA 02301
Phone (508) 427-4383

104 Torrey St
Brockton, MA 02301
Phone (508) 274-4383

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738368000000",
    "number": "1124619291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 MONTELLO ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023016657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 TORREY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014855",
            "telephone_number": "508-427-4383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "DANYELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2025-02-01",
        "certification_date": "2025-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "LMHC10002583",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.