Jack Fredric Leiderman, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

07933 Issued in MD

Practice address

PO Box 10475
Rockville, MD 20849-0475

Phone

(240) 731-5353

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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.

Opted out of Medicare

Yes, effective Oct 1, 2012 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Symphony Diagnostic Services No 1 LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Hunt Valley, MD
  • NPI 1700865094
  NPD (past)
• Threshold Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Silver Spring, MD
  • NPI 1255379947
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764374400000",
    "number": "1033267802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10475",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208490475",
            "telephone_number": "240-731-5353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 10475",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208490475",
            "telephone_number": "240-731-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIDERMAN",
        "first_name": "JACK",
        "middle_name": "FREDRIC",
        "name_prefix": "Mr.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2025-11-29",
        "certification_date": "2025-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "07933",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904004377",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC302377",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sippora Michelle Lehrhaupt, P.A.-C
• Nadia Lehtihet, MD
• Susan Leibenhaut, M.D.
• Blake Leibowitz, PA-C
• Nadia Leiby
• Shanice Leigh Cabrera
• Kellie Ann Leighton-Oppler
• Lance G Leithauser, M.D.
• Sara Beth Leitheiser, MD
• Damaris Leiva Hernandez

• Clinical Social Worker in Rockville, MD
• Providers in Rockville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.