Active NPI
Judith Leichtberg, LCSW
- Clinical Social Worker
- Farmington, CT
National Provider Identifier
1003875758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 003489
- Practice address
- 1301 Farmington Ave
Farmington, CT 06032 - Phone
- (860) 677-2550
- Fax
- (860) 677-4975
- NPI assigned
- Mar 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 003489 | CT | Primary |
Addresses
Primary practice location
1301 Farmington Ave
Farmington, CT 06032
Mailing address
1301 Farmington Ave
Farmington, CT 06032
Phone (860) 677-2550
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 211793 | Other | CT | MANAGED HEALTH NET |
| 140003489CT04 | Other | CT | ANTHEM BC |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Hospital of Central Connecticut at New Britain General and Bradley | Past | 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.
-
- General Acute Care Hospital
- New Britain, CT
- NPI 1053477075
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197849600000",
"number": "1003875758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 FARMINGTON AVE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "06032",
"telephone_number": "860-677-2550",
"fax_number": "860-677-4975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 FARMINGTON AVE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "06032",
"telephone_number": "860-677-2550",
"fax_number": "860-677-4975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEICHTBERG",
"first_name": "JUDITH",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-03-21",
"last_updated": "2007-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "003489",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NET",
"identifier": "211793",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC",
"identifier": "140003489CT04",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.