Individual provider Active NPI

Ann Marie Leasher, LMSW, CADC, SPADA

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1417222498
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801078094 Issued in MI
Practice address
555 Mid Towne NE Suite 304
Psychology Associates of Grand Rapids, PC
Grand Rapids, MI 49503
Phone
(616) 458-4444
Fax
(616) 458-4440
NPI assigned
Mar 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801078094 MI Primary

Addresses

Primary practice location

555 Mid Towne NE Suite 304
Psychology Associates of Grand Rapids, PC
Grand Rapids, MI 49503

Mailing address

1000 Parchment Dr. SE
Psychology Associates of Grand Rapids, PC
Grand Rapids, MI 49546
Phone (616) 957-9112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20121009000429 MI Practitioner - Clinical Social Worker 5294984134 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1000 Parchment Dr SE
Grand Rapids, MI 49546-3663
Phone (616) 957-9112

555 Midtowne St NE
Suite 304
Grand Rapids, MI 49503-5731
Phone (616) 458-4444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Associates of Grand Rapids PC CurrentSince Sep 17, 2012 Accepting new patients
Psychology Associates of Grand Rapids PC CurrentSince Sep 17, 2012 Accepting new patients

Locations

1000 Parchment Dr SE
Grand Rapids, MI 49546
Phone (616) 957-9112

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1417222498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 PARCHMENT DR. SE",
            "address_2": "PSYCHOLOGY ASSOCIATES OF GRAND RAPIDS, PC",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-957-9112",
            "fax_number": "616-957-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MID TOWNE NE SUITE 304",
            "address_2": "PSYCHOLOGY ASSOCIATES OF GRAND RAPIDS, PC",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-458-4444",
            "fax_number": "616-458-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEASHER",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "LMSW, CADC, SPADA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801078094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.