Individual provider Active NPI

John J Leach, LCSW., CART

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1003823824
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19462 Issued in TX
Practice address
12416 Hymeadow Dr Ste 207
Austin, TX 78750-2283
Phone
(877) 519-1144
Fax
(254) 519-1155
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 19462 TX Primary

Addresses

Primary practice location

12416 Hymeadow Dr Ste 207
Austin, TX 78750-2283

Mailing address

2031 Whitney Bay Dr
Rockwall, TX 75087-2431
Phone (469) 303-7000

Other identifiers 1

IdentifierTypeStateIssuer
162861201MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19462TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Counseling Associates PLLC Mental Health PastSince May 17, 2015 Accepting new patients

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1003823824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2031 WHITNEY BAY DR",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750872431",
            "telephone_number": "469-303-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12416 HYMEADOW DR STE 207",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787502283",
            "telephone_number": "877-519-1144",
            "fax_number": "254-519-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "LCSW., CART",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "19462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162861201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.