Individual provider Active NPI

Madeline Jane Leach, LCSW, CADC

  • Clinical Social Worker
  • Fort Washington, PA
National Provider Identifier
1306103197
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW014757 Issued in PA
Practice address
550 Pinetown Rd
Suite 301C
Fort Washington, PA 19034-2605
Phone
(215) 630-6078
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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 SW014757 PA Primary

Addresses

Primary practice location

550 Pinetown Rd
Suite 301C
Fort Washington, PA 19034-2605

Mailing address

550 Pinetown Rd
Suite 301C
Fort Washington, PA 19034-2605
Phone (215) 630-6078

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 12, 2024 through Jan 12, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW014757PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1306103197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 PINETOWN RD",
            "address_2": "SUITE 301C",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342605",
            "telephone_number": "215-630-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 PINETOWN RD",
            "address_2": "SUITE 301C",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342605",
            "telephone_number": "215-630-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "MADELINE",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "SW014757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, PA

Sources for this page

Verify at the official NPI Registry.