Active NPI
Leah Logan
- Clinical Social Worker
- Boise, ID
National Provider Identifier
1194148635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-36482
- Practice address
- 223 N 6TH St Ste 405
Boise, ID 83702-6082 - Phone
- (208) 704-2166
- NPI assigned
- Feb 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-36482 | ID | Primary |
Addresses
Primary practice location
223 N 6TH St Ste 405
Boise, ID 83702-6082
Mailing address
5917 W Robertson Dr
Boise, ID 83709-2166
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Sep 26, 2019 through Sep 26, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-36482 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686614400000",
"number": "1194148635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5917 W ROBERTSON DR",
"city": "BOISE",
"state": "ID",
"postal_code": "837092166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 N 6TH ST STE 405",
"city": "BOISE",
"state": "ID",
"postal_code": "837026082",
"telephone_number": "208-704-2166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "LEAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-02-03",
"last_updated": "2023-06-13",
"certification_date": "2023-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-36482",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.