Active NPI
Leigh S. Ivey, LMSW
- Clinical Social Worker
- Tyler, TX
National Provider Identifier
1366486649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- S14887
- Practice address
- 2323 W Front St
Tyler, TX 75702-7704 - Phone
- (903) 597-1351
- Fax
- (903) 535-7386
- NPI assigned
- Jun 16, 2006
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | S14887 | TX | Primary |
Addresses
Primary practice location
2323 W Front St
Tyler, TX 75702-7704
Mailing address
2323 W Front St
Tyler, TX 75702-7704
Phone (903) 597-1351
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100896302 | Medicaid | TX | |
| 800008480 | Other | TX | RAILROAD MEDICARE |
| 86258A | Other | TX | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S14887 | TX | MD | Clinical Social Worker |
| 14887 | TX | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Andrews Center - Elliott St | 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.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Canton, TX
- NPI 1467900738
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224633600000",
"number": "1366486649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2323 W FRONT ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757027704",
"telephone_number": "903-597-1351",
"fax_number": "903-535-7386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2323 W FRONT ST",
"city": "TYLER",
"state": "TX",
"postal_code": "757027704",
"telephone_number": "903-597-1351",
"fax_number": "903-535-7386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVEY",
"first_name": "LEIGH",
"middle_name": "S.",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-16",
"last_updated": "2008-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "S14887",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100896302",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "800008480",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "86258A",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.