Jud Eugene Leifheit, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-29491 Issued in ID

Practice address

1110 W Park PL Ste 305
Coeur D Alene, ID 83814-2784

Phone

(208) 667-6606

Fax

(208) 765-3051

NPI assigned

Jun 11, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1093036147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W PARK PL STE 305",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142784",
            "telephone_number": "208-667-6606",
            "fax_number": "208-765-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 W PARK PL STE 305",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142784",
            "telephone_number": "208-667-6606",
            "fax_number": "208-765-3051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 N Syringa St Ste 205",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838545275",
            "country_code": "US",
            "telephone_number": "208-262-0945",
            "fax_number": "208-415-0150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIFHEIT",
        "first_name": "JUD",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-29491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093036147",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Everett Leeth, FNP, PMHNP
• Legends Park Community Healthcare LLC
• Legends Park LLC
• Hannah Jean Lehrsch, LM, CPM
• Peter John Leichtnam
• Tori Christine Lennox
• Leonard D. Guth MD PC
• Joshua Leppert, CRNA
• Robert J Leppert, CRNA
• Cassy Elberta Margart Lester, FNP-C

• All providers in Coeur D Alene, ID
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.