Leah E Fondaw, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1350 Issued in KY

Practice address

425 Broadway St
Paducah, KY 42001-0713

Phone

(270) 442-7121

NPI assigned

May 4, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Ky Regional MHMR Board IncGroup PAC ID 0446154587, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Western Ky Regional MHMR Board Inc

  dba Four Rivers Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Paducah, KY
  • NPI 1841216934

  Mental Health (Including Community Mental Health Center)

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1245558097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420010713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 BROADWAY ST",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420010713",
            "telephone_number": "270-442-7121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONDAW",
        "first_name": "LEAH",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-04",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "1350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000673315",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie S Floyd
• Flynn & Owen Counseling Services
• Flynn Counseling Services PLLC
• Jill L Flynn, LCSW
• Mary E. Foley, PSYD
• Michelle Fondaw
• Ford Dermatology, PLLC
• Halden H Ford, M.D.
• Haley Gail Ford
• James Kenneth Ford, M.D.

• Clinical Social Worker in Paducah, KY
• Providers in Paducah, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.