Individual provider Active NPI

Stacey H. Leuci, LCSW

  • Social Worker
  • Port Jefferson Station, NY
National Provider Identifier
1801996178
Registry record updated Apr 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
073517-1 Issued in NY
Practice address
3 Premier CT
Port Jefferson Station, NY 11776-3198
Phone
(631) 476-7119
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2012

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 073517-1 NY Primary

Addresses

Primary practice location

3 Premier CT
Port Jefferson Station, NY 11776-3198

Mailing address

3 Premier CT
Port Jefferson Station, NY 11776-3198
Phone (631) 476-7119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130903000692 NY Practitioner - Clinical Social Worker 1557504974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ernest Leuci LCSW PCGroup PAC ID 8325041874, 2 clinicians

Practice addresses (Care Compare)

3 Premier CT
Port Jefferson Station, NY 11776-3198
Phone (633) 476-7119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073517-1NYMDSocial Worker

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1801996178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PREMIER CT",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763198",
            "telephone_number": "631-476-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PREMIER CT",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763198",
            "telephone_number": "631-476-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEUCI",
        "first_name": "STACEY",
        "middle_name": "H.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "073517-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

Verify at the official NPI Registry.