Individual provider Active NPI

Karen M Leblang, LCSW

  • Social Worker
  • Prescott Valley, AZ
National Provider Identifier
1730178856
Registry record updated Nov 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW107091 Issued in AZ
Practice address
8141 E Florentine Rd
Suite B
Prescott Valley, AZ 86314-9427
Phone
(928) 759-8998
Fax
(928) 759-9209
NPI assigned
Oct 20, 2005
Last updated
Nov 21, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCSW107091 AZ Primary

Addresses

Primary practice location

8141 E Florentine Rd
Suite B
Prescott Valley, AZ 86314-9427

Mailing address

8141 E Florentine Rd
Prescott Valley, AZ 86314-9427
Phone (928) 759-8998

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
I20160225002472 FL Practitioner - Clinical Social Worker 4880660240 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW107091AZMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Assessment and Counseling Inc Social Worker CurrentSince Dec 15, 2015 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1730178856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8141 E FLORENTINE RD",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863149427",
            "telephone_number": "928-759-8998",
            "fax_number": "928-759-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8141 E FLORENTINE RD",
            "address_2": "SUITE B",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863149427",
            "telephone_number": "928-759-8998",
            "fax_number": "928-759-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANG",
        "first_name": "KAREN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LCSW107091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

Verify at the official NPI Registry.