Individual provider Active NPI

Leah L Pace, LMSW

  • Social Worker
  • Shreveport, LA
National Provider Identifier
1275907560
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
13911 Issued in LA
Practice address
4571 N Market St
Shreveport, LA 71107
Phone
(318) 424-8735
Fax
(318) 424-8739
NPI assigned
Nov 24, 2015
Last updated
Jul 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 13911 LA Primary
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

4571 N Market St
Shreveport, LA 71107

Mailing address

4571 N Market St
Shreveport, LA 71107-2917
Phone (318) 424-8735

Other practice location 1

4601 N Market St Ste 2
Shreveport, LA 71107
Phone (318) 426-8096

Other practice location 2

856 Texas Ave
Shreveport, LA 71101-3400
Phone (318) 658-5965

Other practice location 3

4571 N Market St
Shreveport, LA 71107
Phone (318) 424-8735

Other identifiers 1

IdentifierTypeStateIssuer
1417252230MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20231023003645 LA Practitioner - Clinical Social Worker 4688020910 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13911LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Azalea Health Services CurrentSince Sep 29, 2023 Accepting new patients
Azalea Health Services Texas LLC CurrentSince Aug 1, 2024 Accepting new patients
Brighter Future Counseling Services, LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1275907560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4571 N MARKET ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711072917",
            "telephone_number": "318-424-8735",
            "fax_number": "318-424-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4571 N MARKET ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71107",
            "telephone_number": "318-424-8735",
            "fax_number": "318-424-8739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4601 N Market St Ste 2",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "71107",
            "country_code": "US",
            "telephone_number": "318-426-8096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "856 Texas Ave",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711013400",
            "country_code": "US",
            "telephone_number": "318-658-5965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4571 N Market St",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "71107",
            "country_code": "US",
            "telephone_number": "318-424-8735",
            "fax_number": "318-424-8739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACE",
        "first_name": "LEAH",
        "middle_name": "L",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-24",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "13911",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417252230",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.