Individual provider Active NPI

Mary Kathleen Leister, LMSW

  • Social Worker
  • West Des Moines, IA
National Provider Identifier
1780211011
Registry record updated Mar 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
084478 Issued in IA
Practice address
1200 Valley West Dr Ste 508
West Des Moines, IA 50266-1906
Phone
(515) 414-5337
NPI assigned
Mar 25, 2020
Last updated
Mar 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2020

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 084478 IA Primary

Addresses

Primary practice location

1200 Valley West Dr Ste 508
West Des Moines, IA 50266-1906

Mailing address

1800 Grand Ave Apt 256
West Des Moines, IA 50265-5040
Phone (515) 414-5337

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
084478IAMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1780211011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 GRAND AVE APT 256",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502655040",
            "telephone_number": "515-414-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 VALLEY WEST DR STE 508",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661906",
            "telephone_number": "515-414-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISTER",
        "first_name": "MARY",
        "middle_name": "KATHLEEN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IA",
            "license": "084478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.