Individual provider Active NPI

Julie Ann Leatherman, LISW

  • Clinical Social Worker
  • Wauseon, OH
National Provider Identifier
1639580160
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I.1700028 Issued in OH
Practice address
241 Philomena Dr
Wauseon, OH 43567
Phone
(567) 454-0456
NPI assigned
May 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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 I.1700028 OH Primary

Addresses

Primary practice location

241 Philomena Dr
Wauseon, OH 43567

Mailing address

241 Philomena Dr
Wauseon, OH 43567-1357
Phone (567) 454-0456

Other practice location 1

241 Philomena Dr
Wauseon, OH 43567
Phone (567) 454-0456

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address julie.leatherman@swgcares.com

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
I.1700028OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1639580160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 PHILOMENA DR",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671357",
            "telephone_number": "567-454-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 PHILOMENA DR",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "43567",
            "telephone_number": "567-454-0456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "241 Philomena Dr",
            "address_purpose": "LOCATION",
            "city": "Wauseon",
            "state": "OH",
            "postal_code": "43567",
            "country_code": "US",
            "telephone_number": "567-454-0456",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEATHERMAN",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-19",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1700028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "julie.leatherman@swgcares.com",
            "affiliation": "N",
            "address_1": "241 Philomena Dr",
            "city": "Wauseon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435671357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wauseon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.