Individual provider Active NPI

Leland Herman Ross, MSW

  • Clinical Social Worker
  • Eugene, OR
National Provider Identifier
1417253378
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L11045 Issued in OR
Practice address
499 W 4TH Ave
Eugene, OR 97401-2505
Phone
(541) 686-1262
NPI assigned
Feb 9, 2011
Last updated
Nov 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X L11045 OR Primary

Addresses

Primary practice location

499 W 4TH Ave
Eugene, OR 97401-2505

Mailing address

3576 Vernon Way
Eugene, OR 97401-5334
Phone (541) 206-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20230310001000 OR Practitioner - Clinical Social Worker 0941673081 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

7455 SW Beveland Rd
Tigard, OR 97223-8610
Phone (503) 624-2600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L11045ORMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Western Psychological and Counseling Services LLC Mental Health CurrentSince Dec 6, 2022 Accepting new patients
Western Psychological and Counseling Services LLC Mental Health CurrentSince Dec 6, 2022 Accepting new patients

Locations

4185 SW Research Way
Ste 110
Corvallis, OR 97333
Phone (541) 257-5500

66 Club Rd
Ste 120
Eugene, OR 97401
Phone (541) 345-2800

66 Club Rd
Ste 300
Eugene, OR 97401

880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494

7455 SW Beveland Rd
Tigard, OR 97223
Phone (503) 624-2600

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.lelandross@151848.advancedmd-direct.com

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": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732665600000",
    "number": "1417253378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3576 VERNON WAY",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974015334",
            "telephone_number": "541-206-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "499 W 4TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974012505",
            "telephone_number": "541-686-1262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "LELAND",
        "middle_name": "HERMAN",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-09",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L11045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eugene, OR

Sources for this page

Verify at the official NPI Registry.