Individual provider Active NPI

Leslie Waggoner Marchand, LCSW

  • Clinical Social Worker
  • Brenham, TX
National Provider Identifier
1417537424
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
21280 Issued in TX
Practice address
600 N Park St
Brenham, TX 77833-2610
Phone
(979) 337-5800
NPI assigned
Apr 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 21280 TX Primary

Addresses

Primary practice location

600 N Park St
Brenham, TX 77833-2610

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (800) 994-0371

Other names 1

  • Mary Leslie Waggoner Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmarchand1201974@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220922003133 TX Practitioner - Clinical Social Worker 9032594320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1280 Arrington Rd
Suite 200
College Station, TX 77845-8696
Phone (979) 207-6550

600 N Park St
Brenham, TX 77833-2610
Phone (979) 836-6153

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Current Accepting new patients
Scott & White Clinic CurrentSince Jul 14, 2023 Accepting new patients
Scott & White Clinic CurrentSince Jul 14, 2023 Accepting new patients

Locations

600 N Park St
Brenham, TX 77833
Phone (409) 836-6153

1280 Arrington Rd
Ste 200
College Station, TX 77845
Phone (979) 207-6550

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: lmarchand1201974@direct.sw.org

Organizations & group practices 3

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": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1417537424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "800-994-0371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N PARK ST",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778332610",
            "telephone_number": "979-337-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCHAND",
        "first_name": "LESLIE",
        "middle_name": "WAGGONER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "21280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmarchand1201974@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "600 N Park St",
            "city": "Brenham",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778332610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "WAGGONER",
            "middle_name": "LESLIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brenham, TX

Sources for this page

Verify at the official NPI Registry.