Individual provider Active NPI

Leslie Ann Ebert, LCSWC

  • Clinical Social Worker
  • Baltimore, MD
National Provider Identifier
1578629838
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSWC05223 Issued in MD
Practice address
1147 S Hanover St
Baltimore, MD 21230
Phone
(410) 719-9700
NPI assigned
Dec 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSWC05223 MD Primary

Addresses

Primary practice location

1147 S Hanover St
Baltimore, MD 21230

Mailing address

1147 S Hanover Street
Baltimore, MD 21230
Phone (410) 719-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20110919000647 MD Practitioner - Clinical Social Worker 7416128665 Practice locations: Baltimore, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1147 S Hanover St
Baltimore, MD 21230-3717
Phone (410) 719-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSWC05223MDMDClinical Social Worker
05223MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578629838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 S HANOVER STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21230",
            "telephone_number": "410-719-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 S HANOVER ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21230",
            "telephone_number": "410-719-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERT",
        "first_name": "LESLIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSWC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "LCSWC05223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.