Individual provider Active NPI

Leslie Suzanne Ortiz Montenegro, MSW, LCSW

  • Clinical Social Worker
  • Los Angeles, CA
National Provider Identifier
1669998209
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
125251 Issued in CA
Practice address
2735 Alsace Ave
Los Angeles, CA 90016-2707
Phone
(310) 986-4876
NPI assigned
Aug 15, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 78793 CA
Clinical Social Worker 1041C0700X 78793 CA
Clinical Social Worker 1041C0700X 117871 CA
Clinical Social Worker 1041C0700X 125251 CA Primary

Addresses

Primary practice location

2735 Alsace Ave
Los Angeles, CA 90016-2707

Mailing address

2735 Alsace Ave
Los Angeles, CA 90016-2707
Phone (310) 986-4876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250120000646 CA Practitioner - Clinical Social Worker 6800325978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mood Clinical, P. C.Group PAC ID 4981080769, 107 clinicians

Practice addresses (Care Compare)

18191 Von Karman Ave
Suite 100
Irvine, CA 92612-7103
Phone (619) 639-9730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117871CAMDClinical Social Worker
125251CAMDClinical Social Worker
78793CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
El Centro del Pueblo, Inc. PastSince Jul 1, 2023 Accepting new patients
Glenn Medical Center, LLC PastSince Nov 16, 2024 Accepting new patients

Organizations & group practices 3

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": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1669998209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2735 ALSACE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900162707",
            "telephone_number": "310-986-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2735 ALSACE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900162707",
            "telephone_number": "310-986-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTENEGRO",
        "first_name": "LESLIE",
        "middle_name": "SUZANNE ORTIZ",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "78793",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "78793",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "117871",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "125251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.