Individual provider Active NPI

Nancy Wagner Leonardson, M.A. AND L.M.H.C..

  • Mental Health Counselor
  • Monroe, WA
National Provider Identifier
1053436972
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH00007544 Issued in WA
Practice address
125 E Main St
Suite 201
Monroe, WA 98272-1543
Phone
(360) 794-1951
Fax
(360) 794-6711
NPI assigned
Mar 20, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH00007544 WA Primary

Addresses

Primary practice location

125 E Main St
Suite 201
Monroe, WA 98272-1543

Mailing address

125 E Main St
Suite 201
Monroe, WA 98272-1543
Phone (360) 794-1951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240830000603 WA Practitioner - Mental Health Counselor 3173062452 Practice locations: Monroe, WA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053436972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E MAIN ST",
            "address_2": "SUITE 201",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721543",
            "telephone_number": "360-794-1951",
            "fax_number": "360-794-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E MAIN ST",
            "address_2": "SUITE 201",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721543",
            "telephone_number": "360-794-1951",
            "fax_number": "360-794-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARDSON",
        "first_name": "NANCY",
        "middle_name": "WAGNER",
        "credential": "M.A. AND L.M.H.C..",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00007544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, WA

Sources for this page

Verify at the official NPI Registry.