Individual provider Active NPI

Leah Jean Johnson, MSW, LMSW-C

  • Clinical Social Worker
  • West Bloomfield, MI
National Provider Identifier
1215707237
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801118100 Issued in MI
Practice address
6960 Orchard Lake Rd Ste 202
West Bloomfield, MI 48322-4519
Phone
(248) 985-9942
Fax
(248) 221-1775
NPI assigned
Jan 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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 6801118100 MI Primary

Addresses

Primary practice location

6960 Orchard Lake Rd Ste 202
West Bloomfield, MI 48322-4519

Mailing address

502 E Cesar E Chavez Ave Apt 202
Lansing, MI 48906-4447
Phone (407) 575-1910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20240919002742 MI Practitioner - Clinical Social Worker 9436690203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ellie Mental Health Live Authentic PLLCGroup PAC ID 0648644658, 5 clinicians

Practice addresses (Care Compare)

41800 W 11 Mile Rd
Suite 110
Novi, MI 48375-1818
Phone (947) 219-1283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801118100MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ellie Mental Health Live Authentic PLLC CurrentSince Aug 8, 2024 Accepting new patients
Emhpe Michigan PLLC Clinical PastSince Jan 1, 2024 Accepting new patients

Locations

41800 W 11 Mile Rd
Ste 110
Novi, MI 48375
Phone (877) 693-5543

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1215707237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 E CESAR E CHAVEZ AVE APT 202",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489064447",
            "telephone_number": "407-575-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6960 ORCHARD LAKE RD STE 202",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483224519",
            "telephone_number": "248-985-9942",
            "fax_number": "248-221-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LEAH",
        "middle_name": "JEAN",
        "credential": "MSW, LMSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801118100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

Verify at the official NPI Registry.