Individual provider Active NPI

Leah Marie Lewis, LICSW

  • Clinical Social Worker
  • Plymouth, MN
National Provider Identifier
1053973719
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
35600 Issued in MN
Practice address
2855 Campus Dr Ste 660
Plymouth, MN 55441-2665
Phone
(763) 577-7900
Fax
(763) 577-7905
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 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 L11238 OR
Clinical Social Worker 1041C0700X 35600 MN Primary

Addresses

Primary practice location

2855 Campus Dr Ste 660
Plymouth, MN 55441-2665

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Other practice location 1

63311 Jamison St
Bend, OR 97703-8288
Phone (541) 585-7210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230406001829 OR Practitioner - Clinical Social Worker 8628443538 Reassigns benefits to 2 organizations
I20260202001023 MN Practitioner - Clinical Social Worker 8628443538 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 43
Minneapolis, MN 55440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
35600MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Mar 20, 2026 Accepting new patients
Deschutes County Oregon CurrentSince Mar 1, 2023 Accepting new patients
Deschutes County Oregon CurrentSince Mar 1, 2023 Accepting new patients
Allina Health System CurrentSince Mar 20, 2026 Accepting new patients
Deschutes County Oregon Current Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince Sep 1, 2025 Accepting new patients

Locations

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

800 E 28th St
Fl 6
Minneapolis, MN 55407
Phone (612) 863-5327

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

2855 Campus Dr
Ste 660
Plymouth, MN 55441
Phone (763) 577-7900

2577 NE Courtney Dr
Bend, OR 97701
Phone (541) 322-7400

63311 Jamison St
Bend, OR 97703
Phone (541) 332-7500

1128 NW Harriman St
Bend, OR 97703
Phone (541) 322-7457

Organizations & group practices 7

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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1053973719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 CAMPUS DR STE 660",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554412665",
            "telephone_number": "763-577-7900",
            "fax_number": "763-577-7905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "63311 Jamison St",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977038288",
            "country_code": "US",
            "telephone_number": "541-585-7210",
            "fax_number": "541-322-7565",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "LEAH",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-02",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11238",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "35600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

Verify at the official NPI Registry.