Leslie Diane Reambeault, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149008906 Issued in IL

Practice address

5115 N Ravenswood Ave
Second Floor
Chicago, IL 60640-2712

Phone

(773) 230-5109

Fax

(773) 275-1494

NPI assigned

Sep 14, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233014400000",
    "number": "1295830297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 N RAVENSWOOD AVE",
            "address_2": "SECOND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402712",
            "telephone_number": "773-230-5109",
            "fax_number": "773-275-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 N RAVENSWOOD AVE",
            "address_2": "SECOND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402712",
            "telephone_number": "773-230-5109",
            "fax_number": "773-275-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REAMBEAULT",
        "first_name": "LESLIE",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2009-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149008906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VMC",
            "identifier": "021185",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "01627003",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2009; 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.