Individual provider Active NPI

Stephanie Dana Leyba, BA, CACI

  • Addiction (Substance Use Disorder) Counselor
  • Pueblo, CO
National Provider Identifier
1841704897
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
ACA0007578 Issued in CO
Practice address
3500 Baltimore Ave
Pueblo, CO 81008-1543
Phone
(719) 545-1181
Fax
(719) 545-1191
NPI assigned
Nov 29, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACA0007578 CO Primary

Addresses

Primary practice location

3500 Baltimore Ave
Pueblo, CO 81008-1543

Mailing address

3500 Baltimore Ave
Pueblo, CO 81008-1543
Phone (719) 545-1181

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
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
ACA0007578COMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1841704897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 BALTIMORE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081543",
            "telephone_number": "719-545-1181",
            "fax_number": "719-545-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 BALTIMORE AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081543",
            "telephone_number": "719-545-1181",
            "fax_number": "719-545-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYBA",
        "first_name": "STEPHANIE",
        "middle_name": "DANA",
        "credential": "BA, CACI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-29",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACA0007578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; 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.