Active NPI
Leandra Sullivan, LCSW
- Clinical Social Worker
- South Pasadena, CA
National Provider Identifier
1073168720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 122899
- Practice address
- 503 Fair Oaks Ave.
South Pasadena, CA 91030 - Phone
- (626) 655-3195
- NPI assigned
- Aug 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 122899 | CA | Primary |
Addresses
Primary practice location
503 Fair Oaks Ave.
South Pasadena, CA 91030
Mailing address
447 Concord Ave
Monrovia, CA 91016-2002
Phone (626) 524-9551
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122899 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730678400000",
"number": "1073168720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "447 CONCORD AVE",
"city": "MONROVIA",
"state": "CA",
"postal_code": "910162002",
"telephone_number": "626-524-9551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 FAIR OAKS AVE.",
"city": "SOUTH PASADENA",
"state": "CA",
"postal_code": "91030",
"telephone_number": "626-655-3195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "LEANDRA",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-08",
"last_updated": "2024-11-04",
"certification_date": "2024-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "122899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Pasadena, CA
- Annette Stollsteimer, LAC
- Jennifer Jill Stratton
- Angela Richelle Sublett
- Isabella Sugiura
- Joshua Patrick Sullivan, LCSW
- Connie Xiao Sun, L.C.S.W.
- Sunrise Therapy Center(STC) Marriage Family and Child Counseling, Inc. (Sunrise Therapy Center Marriage Family and Child Counseling)
- Susan Leung DDS Inc (south pasadena general dentistry inc)
- Beauty Min Khin Myo Swe, MD
- Synergy Therapy Inc (Synergy Speech-Language Pathology)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.