Individual provider Active NPI

Ethan Leichter

  • Social Worker
  • New York, NY
National Provider Identifier
1174702815
Registry record updated Jun 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
82 Nassau St # 151
New York, NY 10038-3703
Phone
(917) 951-6201
NPI assigned
Oct 30, 2007
Last updated
Jun 5, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2013

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 Primary

Addresses

Primary practice location

82 Nassau St # 151
New York, NY 10038-3703

Mailing address

82 Nassau St # 151
New York, NY 10038-3703
Phone (917) 951-6201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20100830000186 NY Practitioner - Clinical Social Worker 0143344010 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Visiting Counseling Services LCSW PLLCGroup PAC ID 7416368212, 5 clinicians

Practice addresses (Care Compare)

3846 Flatlands Ave
FL 2
Brooklyn, NY 11234-3525
Phone (718) 377-5003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1174702815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 NASSAU ST # 151",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100383703",
            "telephone_number": "917-951-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 NASSAU ST # 151",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100383703",
            "telephone_number": "917-951-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEICHTER",
        "first_name": "ETHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-30",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.