Individual provider Active NPI

Matthew C Leisure, MSW, CAC, SAP

  • Social Worker
  • York, PA
National Provider Identifier
1477595890
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW013624 Issued in PA
Practice address
3550 Concord Rd
York, PA 17402-8626
Phone
(717) 851-6340
Fax
(717) 851-6349
NPI assigned
Jun 11, 2006
Last updated
Jul 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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 SW013624 PA Primary

Addresses

Primary practice location

3550 Concord Rd
York, PA 17402-8626

Mailing address

1803 Mount Rose Ave
Suite B3
York, PA 17403-3026
Phone (717) 851-1405

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
SW013624PAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1477595890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 MOUNT ROSE AVE",
            "address_2": "SUITE B3",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174033026",
            "telephone_number": "717-851-1405",
            "fax_number": "717-851-6349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 CONCORD RD",
            "city": "YORK",
            "state": "PA",
            "postal_code": "174028626",
            "telephone_number": "717-851-6340",
            "fax_number": "717-851-6349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISURE",
        "first_name": "MATTHEW",
        "middle_name": "C",
        "credential": "MSW, CAC, SAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW013624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in York, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.