Individual provider Active NPI

Leslie Goertzen, LSCSW

  • Clinical Social Worker
  • Garden City, KS
National Provider Identifier
1558626622
Registry record updated Mar 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8491 Issued in KS
Practice address
531 Campus View St
Garden City, KS 67846-7904
Phone
(620) 275-0644
Fax
(620) 272-0239
NPI assigned
Jul 5, 2012
Last updated
Mar 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2016

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 LMSW 8491 KS
Clinical Social Worker 1041C0700X 8491 KS Primary

Addresses

Primary practice location

531 Campus View St
Garden City, KS 67846-7904

Mailing address

2101 US Highway 50 Byp
Dodge City, KS 67801-2230
Phone (620) 227-8566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20160322001908 KS Practitioner - Clinical Social Worker 9537466347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Compass Behavioral HealthGroup PAC ID 1355323122, 29 clinicians

Practice addresses (Care Compare)

1111 E Spruce St
Garden City, KS 67846-5958
Phone (620) 276-7689

506 Ave L
Dodge City, KS 67801-5319
Phone (620) 227-8566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW 8491KSMDSocial Worker
8491KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Behavioral Health CurrentSince Feb 4, 2016 Accepting new patients
Compass Health Connection Past Accepting new patients
Compass Behavioral Health PastSince Jun 4, 2023 Accepting new patients

Locations

2101 US Highway 50 Byp
Dodge City, KS 67801
Phone (620) 227-8566

506 Avenue L
Dodge City, KS 67801
Phone (620) 227-8566

1111 E Spruce St
Garden City, KS 67846
Phone (620) 276-7689

531 Campus View St
Garden City, KS 67846
Phone (620) 275-0644

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1558626622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 US HIGHWAY 50 BYP",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012230",
            "telephone_number": "620-227-8566",
            "fax_number": "620-225-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "531 CAMPUS VIEW ST",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678467904",
            "telephone_number": "620-275-0644",
            "fax_number": "620-272-0239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOERTZEN",
        "first_name": "LESLIE",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "LMSW 8491",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "8491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, KS

Sources for this page

Verify at the official NPI Registry.