Individual provider Active NPI

Leslie Coplin

  • Clinical Social Worker
  • Greenwich, CT
National Provider Identifier
1104698968
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13220 Issued in CT
Practice address
67 Holly Hill LN
Greenwich, CT 06830-6072
Phone
(203) 622-1881
Fax
(855) 672-0625
NPI assigned
Oct 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 13220 CT Primary

Addresses

Primary practice location

67 Holly Hill LN
Greenwich, CT 06830-6072

Mailing address

67 Holly Hill LN
Greenwich, CT 06830-6072
Phone (203) 622-1881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20260610001292 CT Practitioner - Clinical Social Worker 3971074923 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
Jewish Family Services of Greenwich IncGroup PAC ID 2062497001, 18 clinicians

Practice addresses (Care Compare)

67 Holly Hill LN
Greenwich, CT 06830-6072
Phone (203) 622-1881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13220CTMDGeneral Practice Dentistry

Organizations & group practices 1

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": "1698192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1104698968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 HOLLY HILL LN",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306072",
            "telephone_number": "203-622-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 HOLLY HILL LN",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068306072",
            "telephone_number": "203-622-1881",
            "fax_number": "855-672-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPLIN",
        "first_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "13220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

Verify at the official NPI Registry.