Individual provider Active NPI

Leanne Mairs, LICSW

  • Clinical Social Worker
  • Shoreview, MN
National Provider Identifier
1053567560
Registry record updated Sep 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16359 Issued in MN
Practice address
1030 County Road E W
Shoreview, MN 55126-8152
Phone
(651) 249-1750
NPI assigned
Aug 15, 2008
Last updated
Sep 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 16359 MN Primary

Addresses

Primary practice location

1030 County Road E W
Shoreview, MN 55126-8152

Mailing address

PO Box 270773
Vadnais Heights, MN 55127-0773
Phone (651) 249-1750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20130820000502 MN Practitioner - Clinical Social Worker 2961644018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1030 W County Rd E
Shoreview, MN 55126
Phone (651) 249-1750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelight Counseling Services, LLC CurrentSince Sep 3, 2021 Accepting new patients
Crossroads: Solutions for Life LLC CurrentSince May 19, 2023 Accepting new patients
Centerlife Counseling, LLC Clinical CurrentSince May 21, 2017 Accepting new patients
Pathway Virtu-Health Past Accepting new patients
Midwest Center for Personal & Family Development PA Past Accepting new patients

Locations

7039 20th Ave
Hugo, MN 55038
Phone (651) 288-0332

1030 County Road E W
Shoreview, MN 55126
Phone (651) 249-1750

1030 County Road E W
Ste 220
Shoreview, MN 55126
Phone (763) 300-0387

4444 Centerville Rd
Ste 235
White Bear Lake, MN 55127
Phone (651) 289-3111

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788739200000",
    "number": "1053567560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270773",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551270773",
            "telephone_number": "651-249-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 COUNTY ROAD E W",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268152",
            "telephone_number": "651-249-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIRS",
        "first_name": "LEANNE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-15",
        "last_updated": "2026-09-07",
        "certification_date": "2026-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreview, MN

Sources for this page

Verify at the official NPI Registry.