Active NPI
Leesa Lynette Allen, LICENSED CLINICAL SO
- Social Worker
- Fresno, CA
National Provider Identifier
1588913883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LCS17521
- Practice address
- 1702 E Bullard Ave Ste 100
Fresno, CA 93710-5800 - Phone
- (559) 283-1463
- Fax
- (559) 438-8354
- NPI assigned
- Aug 31, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LCS17521 | CA | Primary |
Addresses
Primary practice location
1702 E Bullard Ave Ste 100
Fresno, CA 93710-5800
Mailing address
1702 E Bullard Ave Ste 100
Fresno, CA 93710-5800
Phone (559) 283-1463
Other names 1
- Miss Leesa Lynette Balthrop
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 13, 2025 through May 13, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17521 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| LCS17521 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357171200000",
"number": "1588913883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 E BULLARD AVE STE 100",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105800",
"telephone_number": "559-283-1463",
"fax_number": "559-438-8354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 E BULLARD AVE STE 100",
"city": "FRESNO",
"state": "CA",
"postal_code": "937105800",
"telephone_number": "559-283-1463",
"fax_number": "559-438-8354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "LEESA",
"middle_name": "LYNETTE",
"name_prefix": "Mrs.",
"credential": "LICENSED CLINICAL SO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-31",
"last_updated": "2013-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": "LCS17521",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LEESA",
"last_name": "BALTHROP",
"middle_name": "LYNETTE",
"prefix": "MISS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.