Individual provider Active NPI

Laura J Leblanc

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1427105352
Registry record updated Feb 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8521-123 Issued in WI
Practice address
727 Clark CT
Madison, WI 53715-1421
Phone
(773) 844-8389
Fax
(773) 681-7488
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2017

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 149010106 IL
Clinical Social Worker 1041C0700X 8521-123 WI Primary

Addresses

Primary practice location

727 Clark CT
Madison, WI 53715-1421

Mailing address

727 Clark CT
Madison, WI 53715-1421
Phone (773) 844-8389

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 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
I20121129000574 IL Practitioner - Clinical Social Worker 8224280011 Reassigns benefits to 1 organization
I20170228000255 WI Practitioner - Clinical Social Worker 8224280011

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5100 N Ravenswood Ave
Suite 216
Chicago, IL 60640-1710
Phone (773) 844-8389

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486252800000",
    "number": "1427105352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 CLARK CT",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151421",
            "telephone_number": "773-844-8389",
            "fax_number": "773-681-7488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 CLARK CT",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151421",
            "telephone_number": "773-844-8389",
            "fax_number": "773-681-7488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "LAURA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2017-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149010106",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "8521-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.