Individual provider Active NPI

Leslie Fitzwater, LCSW

  • Clinical Social Worker
  • Roswell, NM
National Provider Identifier
1023799509
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWB-2025-1396 Issued in NM
Practice address
300 S Lea Ave # 4
Roswell, NM 88203-4562
Phone
(575) 347-1883
Fax
(737) 201-2725
NPI assigned
Jul 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SWB-2025-1396 NM Primary
Social Worker 104100000X SWB20220948 NM

Addresses

Primary practice location

300 S Lea Ave # 4
Roswell, NM 88203-4562

Mailing address

PO Box 102
Roswell, NM 88202-0102
Phone (575) 347-1883

Other identifiers 1

IdentifierTypeStateIssuer
85109801MedicaidNM

Other names 1

  • Leslie Rhudy, McDaniel, Moore, Fairfield Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260130000760 NM Practitioner - Clinical Social Worker 1759869860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Roswell Infusions LLCGroup PAC ID 1850761099, 2 clinicians

Practice addresses (Care Compare)

300 S Lea Ave
Suite 4
Roswell, NM 88203-4562
Phone (575) 347-1883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SWB20220948NMMDSocial Worker
SWB-2025-1396NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Infusions LLC Social Worker CurrentSince Jan 1, 2026 Accepting new patients
Azurite Services PC CurrentSince Jul 31, 2023 Accepting new patients

Locations

204 W 2nd St
Ste 2
Roswell, NM 88201
Phone (575) 755-5555

313 W Country Club Rd
Ste 9
Roswell, NM 88201
Phone (575) 347-1883

300 S Lea Ave
#4
Roswell, NM 88203
Phone (575) 347-1883

Organizations & group practices 2

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": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1023799509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882020102",
            "telephone_number": "575-347-1883",
            "fax_number": "737-201-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S LEA AVE # 4",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882034562",
            "telephone_number": "575-347-1883",
            "fax_number": "737-201-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZWATER",
        "first_name": "LESLIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2025-1396",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NM",
            "license": "SWB20220948",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85109801",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "RHUDY, MCDANIEL, MOORE, FAIRFIELD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.