Individual provider Active NPI

Kelly M Leach, LCSW

  • Clinical Social Worker
  • Bloomington, IN
National Provider Identifier
1548835796
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34010708A Issued in IN
Practice address
645 S Rogers St
Bloomington, IN 47403-2353
Phone
(812) 339-1691
NPI assigned
May 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 33008773A IN
Clinical Social Worker 1041C0700X 34010708A IN Primary

Addresses

Primary practice location

645 S Rogers St
Bloomington, IN 47403-2353

Mailing address

645 S Rogers St
Bloomington, IN 47403-2353

Other practice location 1

5010 N Stone Mill Rd Ste B
Bloomington, IN 47408-9320
Phone (812) 929-2193

Other practice location 2

950 N Meridian St
Indianapolis, IN 46204-1077
Phone (317) 963-2200

Other identifiers 1

IdentifierTypeStateIssuer
26-3890332MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kleach@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20240322000734 IN Practitioner - Clinical Social Worker 3678910999 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerstone of Indiana IncGroup PAC ID 9436138427, 114 clinicians

Practice addresses (Care Compare)

645 S Rogers St
Bloomington, IN 47403-2353
Phone (812) 339-1691

720 N Marr Rd
Columbus, IN 47201-6660
Phone (812) 314-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33008773AINMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Indiana, Inc. CurrentSince Jul 7, 2025 Accepting new patients
Indiana University Health Care Associates, Inc CurrentSince May 17, 2024 Accepting new patients
Centerstone of Indiana, Inc. Current Accepting new patients
New Outlook Counseling Center Inc PastSince May 1, 2021 Accepting new patients
New Outlook Counseling Center Inc PastSince May 1, 2021 Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

645 S Rogers St
Bloomington, IN 47403
Phone (812) 339-1691

720 N Marr Rd
Columbus, IN 47201
Phone (812) 314-3400

950 N Meridian St
Indianapolis, IN 46204
Phone (317) 963-2200

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

Interoperability endpoints

  • Direct secure messaging: kleach@direct.iuhealth.org

Organizations & group practices 5

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": "1621468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1548835796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "telephone_number": "812-339-1691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5010 N Stone Mill Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474089320",
            "country_code": "US",
            "telephone_number": "812-929-2193",
            "fax_number": "888-789-8394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "950 N Meridian St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462041077",
            "country_code": "US",
            "telephone_number": "317-963-2200",
            "fax_number": "317-963-1621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEACH",
        "first_name": "KELLY",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-20",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "33008773A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34010708A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26-3890332",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kleach@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "950 N Meridian St",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462041077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.