Leeann Jeanette Funk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.009427 Issued in IL

Practice address

310 W Losey St
Family Advocacy Program Building 1533
Scott Air Force Base, IL 62225-5250

Phone

(618) 256-7203

Fax

(618) 256-7246

NPI assigned

Feb 27, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1750418646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2161 NW MILITARY HWY",
            "address_2": "CMSE SUITE 308",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131878",
            "telephone_number": "210-341-3336",
            "fax_number": "210-341-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W LOSEY ST",
            "address_2": "FAMILY ADVOCACY PROGRAM BUILDING 1533",
            "city": "SCOTT AIR FORCE BASE",
            "state": "IL",
            "postal_code": "622255250",
            "telephone_number": "618-256-7203",
            "fax_number": "618-256-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "LEEANN",
        "middle_name": "JEANETTE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2001004059",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.009427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Cowen, IDMT
• Caitlin M Cox
• Anick Diessongo
• Sheila Bonnie Durlester, PNP
• Cheryl Lynn Frietch, R.D.
• Michelle Kay Garris, CCC-SLP
• Joseph William Glovacz Jr., PHARM.D.
• Sarah Nicole Gore, O.D.
• Jennifer Renee Hardin, CNS
• Jeffrey Roger Herchler, APA-C

• Clinical Social Worker in Scott Air Force Base, IL
• Providers in Scott Air Force Base, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.