Individual provider Active NPI

Leslie Louise Corneau

  • Clinical Social Worker
  • Shelby Township, MI
National Provider Identifier
1760079966
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801086857 Issued in MI
Practice address
2307 Benedict LN
Shelby Township, MI 48316-2005
Phone
(248) 231-5762
NPI assigned
Dec 22, 2020
Last updated
Dec 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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 6801086857 MI Primary

Addresses

Primary practice location

2307 Benedict LN
Shelby Township, MI 48316-2005

Mailing address

2307 Benedict LN
Shelby Township, MI 48316-2005
Phone (248) 231-5762

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
6801086857MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1760079966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2307 BENEDICT LN",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483162005",
            "telephone_number": "248-231-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2307 BENEDICT LN",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483162005",
            "telephone_number": "248-231-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORNEAU",
        "first_name": "LESLIE",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801086857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.