Individual provider Active NPI

Tiffany Leonard, LMHC

  • Mental Health Counselor
  • Bloomington, IN
National Provider Identifier
1821313834
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002152 Issued in IN
Practice address
482 S Landmark Ave
Bloomington, IN 47403-5000
Phone
(812) 333-8474
Fax
(812) 961-3804
NPI assigned
Apr 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39002152 IN Primary

Addresses

Primary practice location

482 S Landmark Ave
Bloomington, IN 47403-5000

Mailing address

482 S Landmark Ave
Bloomington, IN 47403-5000
Phone (812) 333-8474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20231130002402 IN Practitioner - Mental Health Counselor 8628426657 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39002152INMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Spencer PHD HSPP PC CurrentSince Jan 1, 2024 Accepting new patients
Stone Belt Arc, Inc. PastSince Feb 1, 2005 Accepting new patients

Locations

482 S Landmark Ave
Bloomington, IN 47403
Phone (812) 333-8474

1312 W Arch Haven Ave
Ste A
Bloomington, IN 47403
Phone (812) 333-8474

Organizations & group practices 2

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": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1821313834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "482 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035000",
            "telephone_number": "812-333-8474",
            "fax_number": "812-961-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "482 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035000",
            "telephone_number": "812-333-8474",
            "fax_number": "812-961-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "TIFFANY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-01",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.