Active NPI
David Anthony Leos Jr.
- Social Worker
- Lawrenceville, GA
National Provider Identifier
1841038304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- MSW011830
- Practice address
- 175 Gwinnett Dr
Lawrenceville, GA 30046-8444 - Phone
- (678) 209-2394
- NPI assigned
- Jul 18, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MSW011830 | GA | Primary |
Addresses
Primary practice location
175 Gwinnett Dr
Lawrenceville, GA 30046-8444
Mailing address
364 Salem Glen Way SE
Conyers, GA 30013-5337
Phone (810) 845-5762
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
| License | State | Type | Specialty |
|---|---|---|---|
| MSW011830 | GA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721260800000",
"number": "1841038304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "364 SALEM GLEN WAY SE",
"city": "CONYERS",
"state": "GA",
"postal_code": "300135337",
"telephone_number": "810-845-5762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 GWINNETT DR",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300468444",
"telephone_number": "678-209-2394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEOS",
"first_name": "DAVID",
"middle_name": "ANTHONY",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-07-18",
"last_updated": "2024-07-18",
"certification_date": "2024-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "GA",
"license": "MSW011830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.