Provider Demographics
NPI:1295535318
Name:LABRANCHE, MARC J
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:J
Last Name:LABRANCHE
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3634 DAVENPORT CREEK CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-4658
Mailing Address - Country:US
Mailing Address - Phone:321-245-1563
Mailing Address - Fax:
Practice Address - Street 1:3634 DAVENPORT CREEK CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746-4658
Practice Address - Country:US
Practice Address - Phone:321-245-1563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW216281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical