Individual provider Active NPI

Karin K Leden, MSW, APSW, LSW, LCSW

  • Clinical Social Worker
  • Rockford, IL
National Provider Identifier
1740635218
Registry record updated Dec 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.020380 Issued in IL
Practice address
6653 Weaver Rd Ste 105
Rockford, IL 61114-8052
Phone
(815) 742-7516
NPI assigned
May 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150101553 IL
Social Worker 104100000X 129829121 WI
Clinical Social Worker 1041C0700X 9011-123 WI
Clinical Social Worker 1041C0700X 149.020380 IL Primary

Addresses

Primary practice location

6653 Weaver Rd Ste 105
Rockford, IL 61114-8052

Mailing address

208 Renrose Ave
Loves Park, IL 61111-4046
Phone (815) 742-7516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20190128002808 IL Practitioner - Clinical Social Worker 8921345026 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6653 Weaver Rd
Suite 105
Rockford, IL 61114-8068
Phone (815) 988-2524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
150101553ILMDSocial Worker
129829121WIMDSocial Worker
149.020380ILMDClinical Social Worker
9011-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center for the Healing Mind PLLC CurrentSince Dec 1, 2018 Accepting new patients

Locations

6653 Weaver Rd
Ste 105
Rockford, IL 61114
Phone (815) 742-7516

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1462233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544659200000",
    "number": "1740635218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 RENROSE AVE",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611114046",
            "telephone_number": "815-742-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6653 WEAVER RD STE 105",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611148052",
            "telephone_number": "815-742-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDEN",
        "first_name": "KARIN",
        "middle_name": "K",
        "credential": "MSW, APSW, LSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-03",
        "last_updated": "2018-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150101553",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "129829121",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9011-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.020380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.