Active NPI
Jenna Kayleene Leeson
- Social Worker
- Valley Stream, NY
National Provider Identifier
1104691625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 120786
- Practice address
- 50 W Hawthorne Ave
Valley Stream, NY 11580-6223 - Phone
- (516) 569-6600
- NPI assigned
- Nov 15, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 120786 | NY | Primary |
Addresses
Primary practice location
50 W Hawthorne Ave
Valley Stream, NY 11580-6223
Mailing address
776 6TH Ave Apt 10E
New York, NY 10001-0165
Phone (424) 303-2590
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 |
|---|---|---|---|
| 120786 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700006400000",
"number": "1104691625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "776 6TH AVE APT 10E",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100010165",
"telephone_number": "424-303-2590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 W HAWTHORNE AVE",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115806223",
"telephone_number": "516-569-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEESON",
"first_name": "JENNA",
"middle_name": "KAYLEENE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-11-15",
"last_updated": "2023-11-15",
"certification_date": "2023-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "120786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Stream, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.