Individual provider Active NPI

Leslie Renee Simmons, MSW, LCSWA

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1699299784
Registry record updated Jul 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P011844 Issued in NC
Practice address
5501 Executive Center Dr Ste 238
Charlotte, NC 28212-8867
Phone
(704) 281-0514
NPI assigned
Jul 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2017

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 P011844 NC Primary

Addresses

Primary practice location

5501 Executive Center Dr Ste 238
Charlotte, NC 28212-8867

Mailing address

700 E Stonewall St Ste 601
Charlotte, NC 28202-2781
Phone (980) 355-1428

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P011844NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1501459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501459200000",
    "number": "1699299784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E STONEWALL ST STE 601",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022781",
            "telephone_number": "980-355-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 EXECUTIVE CENTER DR STE 238",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282128867",
            "telephone_number": "704-281-0514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "LESLIE",
        "middle_name": "RENEE",
        "name_prefix": "Miss",
        "credential": "MSW, LCSWA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-31",
        "last_updated": "2017-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P011844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2017; 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.