Sandie Leistiko, MSW, MHP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60073152 Issued in WA

Practice address

1404 Central Ave S
Suite 113
Kent, WA 98032-7433

Phone

(253) 876-7620

Fax

(253) 876-7621

NPI assigned

Dec 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 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

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, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sleistiko1045281@wm.providencedirect.org

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.

• Pacmed Clinics

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1013061217
  Medicare reassignment Care Compare group NPD
• Pacmed Clinics

  • Multi-Specialty Clinic/Center
  • Renton, WA
  • NPI 1720023641
  NPD
• Pacmed Clinics

  • Multi-Specialty Clinic/Center
  • Puyallup, WA
  • NPI 1841550530
  NPD

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1336201730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E OLIVE ST",
            "address_2": "SEATTLE MENTAL HEALTH",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981222735",
            "telephone_number": "206-302-2200",
            "fax_number": "206-302-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 CENTRAL AVE S",
            "address_2": "SUITE 113",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980327433",
            "telephone_number": "253-876-7620",
            "fax_number": "253-876-7621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 S Carr Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Renton",
            "state": "WA",
            "postal_code": "980555802",
            "country_code": "US",
            "telephone_number": "425-227-3700",
            "fax_number": "425-227-3116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEISTIKO",
        "first_name": "SANDIE",
        "credential": "MSW, MHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WA",
            "license": "RC00042775",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60073152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sleistiko1045281@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "601 S Carr Rd Ste 100",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980555802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sandy Lock Lee, LMP
• Won Tae Lee, DOCTOR OF PHARMACY
• Lura Lefevre, EDM
• Venietra Geneal Legette, LMP
• Connie Leibow, PT, LO
• Leland B. Dawson DDS, PS
• Jamie Lemmon, LMP
• Grace Lendsey
• Susanne Maree Lenhardt, MS, LMFT
• Katelyn E Leonard, SLP

• Clinical Social Worker in Kent, WA
• Providers in Kent, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.