Individual provider Active NPI

Leigh Ann Wayna, LMSW

  • Social Worker
  • Madison Heights, MI
National Provider Identifier
1083708614
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801086359 Issued in MI
Practice address
29078 Tawas St
Madison Heights, MI 48071-2541
Phone
(248) 854-1301
NPI assigned
Oct 3, 2006
Last updated
Apr 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801086359 MI Primary

Addresses

Primary practice location

29078 Tawas St
Madison Heights, MI 48071-2541

Mailing address

29078 Tawas St
Madison Heights, MI 48071-2541
Phone (248) 648-1747

Other identifiers 1

IdentifierTypeStateIssuer
6801086359OtherMISTATE LICENSE NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL self-reflections.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240926000746 MI Practitioner - Clinical Social Worker 6204374986 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Self Reflections Counseling LLC Clinical CurrentSince Nov 20, 2022 Accepting new patients
Neighborhood Service Organization CurrentSince Jun 11, 2024 Accepting new patients

Locations

8600 Woodward Ave
Detroit, MI 48202
Phone (313) 875-7601

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, 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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1083708614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29078 TAWAS ST",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480712541",
            "telephone_number": "248-648-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29078 TAWAS ST",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480712541",
            "telephone_number": "248-854-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYNA",
        "first_name": "LEIGH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801086359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "6801086359",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "self-reflections.net",
            "affiliation": "N",
            "endpointDescription": "website",
            "address_1": "29078 Tawas St",
            "city": "Madison Heights",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480712541",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison Heights, MI

Sources for this page

Verify at the official NPI Registry.