Individual provider Active NPI

Eileen Spellacy Leir, CSW-PIP

  • Clinical Social Worker
  • Rapid City, SD
National Provider Identifier
1104892785
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1806 Issued in SD
Practice address
24 East New York
Rapid City, SD 57701-2441
Phone
(605) 342-0504
Fax
(605) 348-0919
NPI assigned
Feb 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1806 SD Primary

Addresses

Primary practice location

24 East New York
Rapid City, SD 57701-2441

Mailing address

PO Box 9462
Rapid City, SD 57709-9462
Phone (605) 342-0504

Other identifiers 3

IdentifierTypeStateIssuer
9233748OtherSDDAKOTA CARE
6571040MedicaidSD
4995473OtherSDBLUE CROSS/BLE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1806SDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104892785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9462",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577099462",
            "telephone_number": "605-342-0504",
            "fax_number": "605-348-0919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 EAST NEW YORK",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577012441",
            "telephone_number": "605-342-0504",
            "fax_number": "605-348-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIR",
        "first_name": "EILEEN",
        "middle_name": "SPELLACY",
        "name_prefix": "Ms.",
        "credential": "CSW-PIP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "1806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTA CARE",
            "identifier": "9233748",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6571040",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLE SHIELD",
            "identifier": "4995473",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rapid City, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.