Individual provider Active NPI

Leigh Regine Westergren, LCSW

  • Clinical Social Worker
  • Buford, GA
National Provider Identifier
1386156263
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW007494 Issued in GA
Practice address
114 E Main St # A1B-20
Buford, GA 30518
Phone
(219) 898-9103
NPI assigned
Oct 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34008607A IN
Clinical Social Worker 1041C0700X CSW007494 GA Primary

Addresses

Primary practice location

114 E Main St # A1B-20
Buford, GA 30518

Mailing address

114 E Main St # A1B-20
Buford, GA 30518
Phone (219) 898-9103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190918001708 IN Practitioner - Clinical Social Worker 1759611718 Reassigns benefits to 1 organization
I20230816003155 GA Practitioner - Clinical Social Worker 1759611718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

115 E Main St
Suite A1B 20
Buford, GA 30518-5727
Phone (219) 898-9103

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Leigh Regine LLC Clinical CurrentSince Jun 1, 2023 Accepting new patients
Porter-Starke Services Inc. CurrentSince Aug 13, 2019 Accepting new patients
Porter-Starke Services Inc. CurrentSince Aug 13, 2019 Accepting new patients

Locations

115 E Main St
Ste A1B
Buford, GA 30518
Phone (470) 594-2570

115 E Main St
Ste A1B20
Buford, GA 30518
Phone (219) 898-9103

601 Wall St
Valparaiso, IN 46383
Phone (219) 806-3011

Interoperability endpoints

  • Direct secure messaging: leighwestergren@tdh.allscriptsdirect.net

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1386156263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 E MAIN ST # A1B-20",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "30518",
            "telephone_number": "219-898-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E MAIN ST # A1B-20",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "30518",
            "telephone_number": "219-898-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTERGREN",
        "first_name": "LEIGH",
        "middle_name": "REGINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008607A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

Verify at the official NPI Registry.