Individual provider Active NPI

Kerry Ann Ledden, LCSW

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1669616280
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0717021 Issued in NY
Practice address
17620 148TH Ave
Jamaica, NY 11434-5518
Phone
(718) 553-1100
Fax
(718) 553-1111
NPI assigned
Apr 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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 0717021 NY Primary

Addresses

Primary practice location

17620 148TH Ave
Jamaica, NY 11434-5518

Mailing address

4908 170TH St
Fresh Meadows, NY 11365-1013
Phone (917) 376-8861

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
0717021NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1669616280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4908 170TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651013",
            "telephone_number": "917-376-8861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17620 148TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114345518",
            "telephone_number": "718-553-1100",
            "fax_number": "718-553-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDDEN",
        "first_name": "KERRY",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0717021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; 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.