Individual provider Active NPI

Leah Telliard, LSW

  • Social Worker
  • Philadelphia, PA
National Provider Identifier
1124371729
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW127885 Issued in PA
Practice address
3975 Conshohocken Ave
Philadelphia, PA 19131
Phone
(215) 879-1000
Fax
(215) 879-8424
NPI assigned
Oct 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW127885 PA Primary

Addresses

Primary practice location

3975 Conshohocken Ave
Philadelphia, PA 19131

Mailing address

201 S 25TH St
Apt 504
Philadelphia, PA 19103-6002
Phone (856) 834-9194

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

LicenseStateTypeSpecialty
SW127885PAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1124371729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S 25TH ST",
            "address_2": "APT 504",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036002",
            "telephone_number": "856-834-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 CONSHOHOCKEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19131",
            "telephone_number": "215-879-1000",
            "fax_number": "215-879-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLIARD",
        "first_name": "LEAH",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW127885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.