Individual provider Active NPI

Kristin Kay Leblanc, BCCC, CTC, CFLE

  • Pastoral Counselor
  • Cumming, GA
National Provider Identifier
1235498726
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pastoral CounselorTaxonomy code 101YP1600X
License
07103690 Issued in GA
Practice address
410 Peachtree Pkwy
Suite 4245
Cumming, GA 30041-7066
Phone
(404) 725-6912
Fax
(678) 513-1077
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X 07103690 GA Primary

Addresses

Primary practice location

410 Peachtree Pkwy
Suite 4245
Cumming, GA 30041-7066

Mailing address

410 Peachtree Pkwy
Suite 4245
Cumming, GA 30041-7066
Phone (404) 725-6912

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
07103690GAMDPastoral Counselor

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1235498726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 PEACHTREE PKWY",
            "address_2": "SUITE 4245",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417066",
            "telephone_number": "404-725-6912",
            "fax_number": "678-513-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PEACHTREE PKWY",
            "address_2": "SUITE 4245",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417066",
            "telephone_number": "404-725-6912",
            "fax_number": "678-513-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "KRISTIN",
        "middle_name": "KAY",
        "credential": "BCCC, CTC, CFLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": "GA",
            "license": "07103690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.