Individual provider Active NPI

Suzanne Marie Leitner, LCSW

  • Clinical Social Worker
  • Pembroke Pines, FL
National Provider Identifier
1669576773
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0004454 Issued in FL
Practice address
2250 NW 136TH Ave
Suite 104
Pembroke Pines, FL 33028
Phone
(954) 437-7072
Fax
(954) 212-5757
NPI assigned
Sep 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 0004454 FL Primary

Addresses

Primary practice location

2250 NW 136TH Ave
Suite 104
Pembroke Pines, FL 33028

Mailing address

2250 NW 136TH Ave
Suite 104
Pembroke Pines, FL 33028
Phone (954) 437-7072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20131017000320 FL Practitioner - Clinical Social Worker 5698671683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2250 NW 136 Ave
Pembroke Pines, FL 33028-2586
Phone (954) 437-7072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0004454FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
SL Therapy, Inc. Clinical CurrentSince Oct 7, 2013 Accepting new patients
West Psychiatric Associates P a PastSince May 1, 2000 Accepting new patients

Locations

600 N Hiatus Rd
Ste 201
Pembroke Pines, FL 33026
Phone (954) 499-2535

2250 NW 136th Ave
Ste 104
Pembroke Pnes, FL 33028
Phone (954) 437-7072

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669576773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 NW 136TH AVE",
            "address_2": "SUITE 104",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33028",
            "telephone_number": "954-437-7072",
            "fax_number": "954-212-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 NW 136TH AVE",
            "address_2": "SUITE 104",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "33028",
            "telephone_number": "954-437-7072",
            "fax_number": "954-212-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITNER",
        "first_name": "SUZANNE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "0004454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.