Individual provider Active NPI

Judy Leon, MSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1215069786
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
000625 Issued in MO
Practice address
4390 Lindell Blvd
Saint Louis, MO 63108-2735
Phone
(314) 533-3567
Fax
(314) 533-3567
NPI assigned
Mar 11, 2007
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 000625 MO Primary

Addresses

Primary practice location

4390 Lindell Blvd
Saint Louis, MO 63108-2735

Mailing address

4390 Lindell Blvd
Saint Louis, MO 63108-2735
Phone (314) 533-3567

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
000625MOMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1173571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215069786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4390 LINDELL BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082735",
            "telephone_number": "314-533-3567",
            "fax_number": "314-533-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4390 LINDELL BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082735",
            "telephone_number": "314-533-3567",
            "fax_number": "314-533-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "JUDY",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "000625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

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.