Active NPI
James Andrew Leathem, LCSW
- Clinical Social Worker
- Boston, MA
National Provider Identifier
1649387150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 012554
- Practice address
- 150 S Huntington Ave
Boston, MA 02130-4817 - Phone
- (203) 638-8590
- NPI assigned
- Aug 23, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 069832-1 | NY | |
| Clinical Social Worker | 1041C0700X | 012554 | CT | Primary |
Addresses
Primary practice location
150 S Huntington Ave
Boston, MA 02130-4817
Mailing address
23 Country Club Rd
Cheshire, CT 06410-1631
Phone (516) 417-1300
Other practice location 1
555 Highland Ave
Cheshire, CT 06410-2255
Phone (475) 224-3033
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012554 | CT | MD | Clinical Social Worker |
| 069832-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1649387150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 COUNTRY CLUB RD",
"city": "CHESHIRE",
"state": "CT",
"postal_code": "064101631",
"telephone_number": "516-417-1300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 S HUNTINGTON AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021304817",
"telephone_number": "203-638-8590"
}
],
"practiceLocations": [
{
"address_1": "555 Highland Ave",
"address_purpose": "LOCATION",
"city": "Cheshire",
"state": "CT",
"postal_code": "064102255",
"country_code": "US",
"telephone_number": "475-224-3033",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEATHEM",
"first_name": "JAMES",
"middle_name": "ANDREW",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-23",
"last_updated": "2023-03-07",
"certification_date": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "069832-1",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "012554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.