Individual provider Active NPI

Carmen Angelina Leonard, LCSW

  • Social Worker
  • Mt. Pleasant, WI
National Provider Identifier
1780101295
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
130757-121 Issued in WI
Practice address
1135 N Greenbay Road
Mt. Pleasant, WI 53406
Phone
(262) 939-2246
NPI assigned
Aug 25, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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 130757-121 WI Primary

Addresses

Primary practice location

1135 N Greenbay Road
Mt. Pleasant, WI 53406

Mailing address

1135 N Green Bay Rd
Mount Pleasant, WI 53406-3501
Phone (262) 939-2246

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
130757-121WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Odyssey Healthcare Operating B, LP Past Accepting new patients
Clinical Psychology Associates, LLC PastSince Nov 24, 2020 Accepting new patients
Dr Tammy Zimmel LLC Past Accepting new patients

Organizations & group practices 3

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": "1503619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686182400000",
    "number": "1780101295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 N GREEN BAY RD",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534063501",
            "telephone_number": "262-939-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 N GREENBAY ROAD",
            "city": "MT. PLEASANT",
            "state": "WI",
            "postal_code": "53406",
            "telephone_number": "262-939-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "CARMEN",
        "middle_name": "ANGELINA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-25",
        "last_updated": "2023-06-08",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "130757-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt. Pleasant, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2023; 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.