Organization Active NPI

Leigh Regine LLC

  • Clinical Social Worker
  • Buford, GA
National Provider Identifier
1669017075
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LEIGH REGINE LLC
Practice address
114 E Main St Ste A1B-20
Buford, GA 30518
Phone
(219) 898-9103
NPI assigned
Nov 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Authorized official

Name
Leigh Regine Westergren, LCSWNPI 1386156263
Title
Owner
Phone
(219) 898-9103

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

114 E Main St Ste A1B-20
Buford, GA 30518

Mailing address

PO Box 2257
Chesterton, IN 46304-0357
Phone (219) 898-9103

Other names 1

  • The Healing Hearts Studio Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230816002966 GA Part B Supplier - Clinic/Group Practice 3577925924 Receives reassigned benefits from 1 practitioner
Practice locations: Buford, GA

National Provider Directory

National Provider Directory

Locations

115 E Main St
Ste A1B20
Buford, GA 30518
Phone (219) 898-9103

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715299200000",
    "number": "1669017075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2257",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463040357",
            "telephone_number": "219-898-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 E MAIN ST STE A1B-20",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "30518",
            "telephone_number": "219-898-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEIGH REGINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-08",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A",
        "authorized_official_last_name": "WESTERGREN",
        "authorized_official_first_name": "LEIGH",
        "authorized_official_middle_name": "REGINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-898-9103",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Healing Hearts Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.