Leisa Jane Vestal, LCSW
Individual provider Active NPI Clinical Social Worker · Marion, VA
NPI 1689417693 · NPPES record last updated Jun 17, 2024
Key facts
- NPI
- 1689417693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 0904016974 (VA)
- Practice address
- 121 Broad St
Marion, VA 24354-2725 - Phone
- (276) 781-5900
- Fax
- (276) 782-9153
- NPI assigned
- Jun 17, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0904016974 | VA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mount Rogers Community Services | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0904016974 | VA | Yes |
Addresses
Primary practice location
121 Broad St
Marion, VA 24354-2725
Mailing address
770 W Ridge Rd
Wytheville, VA 24382-1187
Phone (276) 223-3200
Other names
- Leisa Jane Callahan
Other providers in Marion, VA
- Charlene M Truhlik
- Natalie Elaine Tucker
- Cassandra Eden Untiedt
- Mary Abigail Henley Vencill
- Samuel D Vernon
- Virginia CVS Pharmacy LLC
- Thomas William Voglewede
- Sophia Von Dauber
- Wal-Mart Stores East LP
- Walgreen Co
All providers in Marion, VA · Clinical Social Worker in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.