Active NPI
Leslie L Ingalls, ASW
- Mental Health Counselor
- San Rafael, CA
National Provider Identifier
1346440732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 86753
- Practice address
- 830 B St
San Rafael, CA 94901-3003 - Phone
- (415) 459-5843
- Fax
- (415) 459-5894
- NPI assigned
- Jul 23, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 86753 | CA | Primary |
Addresses
Primary practice location
830 B St
San Rafael, CA 94901-3003
Mailing address
830 B St
San Rafael, CA 94901-3003
Phone (415) 459-5843
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 |
|---|---|---|---|
| 86753 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Homeward Bound of Marin | 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.
-
- Mental Illness Community Based Residential Treatment Facility
- San Rafael, CA
- NPI 1497895189
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546992000000",
"number": "1346440732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 B ST",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949013003",
"telephone_number": "415-459-5843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 B ST",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949013003",
"telephone_number": "415-459-5843",
"fax_number": "415-459-5894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INGALLS",
"first_name": "LESLIE",
"middle_name": "L",
"credential": "ASW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-07-23",
"last_updated": "2019-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "86753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.