Individual provider Active NPI

Leslie Penrod, LSW

  • Professional Counselor
  • Cambridge, OH
National Provider Identifier
1477083715
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
S.1101139 Issued in OH
Practice address
1200 E Wheeling Ave
Cambridge, OH 43725-2510
Phone
(740) 432-1800
Fax
(740) 432-9299
NPI assigned
Jun 19, 2017
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
Professional Counselor 101YP2500X S.1101139 OH Primary

Addresses

Primary practice location

1200 E Wheeling Ave
Cambridge, OH 43725-2510

Mailing address

1200 E Wheeling Ave
Cambridge, OH 43725-2510
Phone (740) 432-1800

Other identifiers 1

IdentifierTypeStateIssuer
2965468MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
S.1101139OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
People to People, LLC. CurrentSince Jul 24, 2022 Accepting new patients

Locations

1200 E Wheeling Ave
Cambridge, OH 43725
Phone (740) 432-1800

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": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1477083715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 E WHEELING AVE",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437252510",
            "telephone_number": "740-432-1800",
            "fax_number": "740-432-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E WHEELING AVE",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437252510",
            "telephone_number": "740-432-1800",
            "fax_number": "740-432-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENROD",
        "first_name": "LESLIE",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "S.1101139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2965468",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.