Leslie Ruth Mudaheranwa, MSW,DDIV, M.TH.,LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

114728 Issued in CA

Practice address

3245 W Stewart Ave
Visalia, CA 93291-3267

Phone

(559) 699-3288

NPI assigned

Oct 6, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Theology

State licenses

Practice roles

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.

• McDermott Counseling, LLC

  • Marriage & Family Therapist
  • Visalia, CA
  • NPI 1437535150
  NPD (past)
• McDermott Individual and Family

  • Marriage & Family Therapist
  • Visalia, CA
  • NPI 1194541987

  Clinical

  NPD (past)

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681516800000",
    "number": "1114524733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 W STEWART AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932913267",
            "telephone_number": "559-308-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 W STEWART AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932913267",
            "telephone_number": "559-699-3288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1118 W Murray Ave",
            "address_purpose": "LOCATION",
            "city": "Visalia",
            "state": "CA",
            "postal_code": "932914718",
            "country_code": "US",
            "telephone_number": "559-699-3288",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUDAHERANWA",
        "first_name": "LESLIE",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "MSW,DDIV, M.TH.,LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-06",
        "last_updated": "2023-04-15",
        "certification_date": "2023-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "114728",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "97247",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spencer Moulton
• Moussa Internal Medicine,Inc
• George J Moussally, MSN,ACNP-BC,CCRN
• Monica Moza
• Mra Enterprises LLC
• Brenda A. Mueller, PHD
• Imad Tuma Mugatash, DDS
• Elizabeth Muigai
• Sumedha Mullick, MS RDN
• Liana Muniz, C037020316

• Clinical Social Worker in Visalia, CA
• Providers in Visalia, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.