Active NPI
Leaf Coleman
- School Social Worker
- Ithaca, NY
National Provider Identifier
1336829951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- 095619
- Practice address
- 1401 N Cayuga St
Ithaca, NY 14850-2101 - Phone
- (607) 274-1232
- NPI assigned
- Jul 19, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 095619 | NY | Primary |
Addresses
Primary practice location
1401 N Cayuga St
Ithaca, NY 14850-2101
Mailing address
400 Lake St
Ithaca, NY 14850-2132
Phone (607) 274-2131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 095619 | NY | MD | School Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ithaca City School District | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Local Education Agency (LEA)
- Ithaca, NY
- NPI 1225185317
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1336829951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 LAKE ST",
"city": "ITHACA",
"state": "NY",
"postal_code": "148502132",
"telephone_number": "607-274-2131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 N CAYUGA ST",
"city": "ITHACA",
"state": "NY",
"postal_code": "148502101",
"telephone_number": "607-274-1232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "LEAF",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-19",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NY",
"license": "095619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ithaca, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.