Individual provider Active NPI

Leslie A Ofner, LCSW

  • Social Worker
  • Watertown, WI
National Provider Identifier
1053398545
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
7112-123 Issued in WI
Practice address
1315 W. Main St
Watertown, WI 53094
Phone
(920) 261-4100
Fax
(920) 261-8801
NPI assigned
Dec 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 7112123 WI
Clinical Social Worker 1041C0700X 7112-123 WI
Social Worker 104100000X 7112-123 WI Primary

Addresses

Primary practice location

1315 W. Main St
Watertown, WI 53094

Mailing address

PO Box 364
Family Resources Associates Inc
Watertown, WI 53094
Phone (920) 261-4100

Other identifiers 1

IdentifierTypeStateIssuer
43566500MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20100612000126 WI Practitioner - Clinical Social Worker 1557491834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Resources Associates IncGroup PAC ID 5991773699, 7 clinicians

Practice addresses (Care Compare)

1315 W Main St
Watertown, WI 53094-3564
Phone 92026141002170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7112123WIMDSocial Worker
7112-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Resources Associates Inc CurrentSince Jun 28, 2011 Accepting new patients
Family Resources Associates Inc Past Accepting new patients

Locations

1315 W Main St
Watertown, WI 53094
Phone (920) 261-4100

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1053398545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 364",
            "address_2": "FAMILY RESOURCES ASSOCIATES INC",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "53094",
            "telephone_number": "920-261-4100",
            "fax_number": "920-261-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 W. MAIN ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "53094",
            "telephone_number": "920-261-4100",
            "fax_number": "920-261-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OFNER",
        "first_name": "LESLIE",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "7112123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7112-123",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "7112-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43566500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, WI

Sources for this page

Verify at the official NPI Registry.