Individual provider Active NPI

Lesley Ann Buck, LCSW

  • Clinical Social Worker
  • Fort George G Meade, MD
National Provider Identifier
1528263167
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076243 Issued in NY
Practice address
Usameddac
2480 Llewellyn Ave
Fort George G Meade, MD 20755
Phone
(347) 623-4483
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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 076243 NY Primary
Clinical Social Worker 1041C0700X 0904013529 VA

Addresses

Primary practice location

Usameddac
2480 Llewellyn Ave
Fort George G Meade, MD 20755

Mailing address

Usameddac
2480 Llewellyn Ave
Fort George G. Meade, MD 20755
Phone (347) 623-4483

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904013529VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
FM Coaching & Counseling LLC Clinical PastSince Jul 25, 2013 Accepting new patients

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1528263167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "USAMEDDAC",
            "address_2": "2480 LLEWELLYN AVE",
            "city": "FORT GEORGE G. MEADE",
            "state": "MD",
            "postal_code": "20755",
            "telephone_number": "347-623-4483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USAMEDDAC",
            "address_2": "2480 LLEWELLYN AVE",
            "city": "FORT GEORGE G MEADE",
            "state": "MD",
            "postal_code": "20755",
            "telephone_number": "347-623-4483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "LESLEY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076243",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013529",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort George G Meade, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; 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.