Individual provider Active NPI

Leigh Ellyn Schnitzer Wolfsthal, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1275720039
Registry record updated Jan 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082087 Issued in NY
Practice address
1149-55 Myrtle Avenue
Brooklyn, NY 11206
Phone
(929) 722-4112
Fax
(718) 919-1535
NPI assigned
Sep 26, 2007
Reactivated
Jan 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05883300 NJ
Clinical Social Worker 1041C0700X 082087 NY Primary

Addresses

Primary practice location

1149-55 Myrtle Avenue
Brooklyn, NY 11206

Mailing address

245 E 63Rd St Apt 215
New York, NY 10065-7453
Phone (646) 643-1185

Other practice location 1

245 E 63rd St Apt 215
New York, NY 10065-7453
Phone (646) 643-1185

Other practice location 2

494 Dumont Ave
Brooklyn, NY 11207-5017
Phone (929) 722-4112

Other practice location 3

937 Fulton St
Brooklyn, NY 11238-2347
Phone (929) 722-4112

Other identifiers 1

IdentifierTypeStateIssuer
04494473MedicaidNY

Other names 1

  • Leigh Wolfsthal Professional name

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05883300NJMDClinical Social Worker
082087NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1275720039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 E 63RD ST APT 215",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100657453",
            "telephone_number": "646-643-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149-55 MYRTLE AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "929-722-4112",
            "fax_number": "718-919-1535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 E 63rd St Apt 215",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100657453",
            "country_code": "US",
            "telephone_number": "646-643-1185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "494 Dumont Ave",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112075017",
            "country_code": "US",
            "telephone_number": "929-722-4112",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "937 Fulton St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112382347",
            "country_code": "US",
            "telephone_number": "929-722-4112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHNITZER WOLFSTHAL",
        "first_name": "LEIGH",
        "middle_name": "ELLYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-14",
        "deactivation_date": "2021-12-22",
        "reactivation_date": "2022-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05883300",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04494473",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEIGH",
            "last_name": "WOLFSTHAL",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.