Active NPI
Debra K Leeds, LCSW
- Clinical Social Worker
- Raleigh, NC
National Provider Identifier
1861450207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C005097
- Practice address
- 154 Mine Lake CT Ste 200
Raleigh, NC 27615-6417 - Phone
- (919) 389-9952
- NPI assigned
- May 3, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C005097 | NC | Primary |
Addresses
Primary practice location
154 Mine Lake CT Ste 200
Raleigh, NC 27615-6417
Mailing address
154 Mine Lake CT Ste 200
Raleigh, NC 27615-6417
Phone (919) 389-9952
Other practice location 1
8352 Six Forks Rd
Suite 104
Raleigh, NC 27615-3054
Phone (919) 782-8642
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C005097 | NC | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovative Interpretations, Inc. | Current | Accepting new patients | |
| Pembroke Psychological Services LLP | Clinical | Past | Accepting new patients |
Locations
8352 Six Forks Rd
Ste 104
Raleigh, NC 27615
Phone (919) 649-4858
154 Mine Lake Ct
#200
Raleigh, NC 27615
Phone (919) 389-9952
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.
-
- Mental Health Counselor
- Raleigh, NC
- NPI 1568495554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548720000000",
"number": "1861450207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "154 MINE LAKE CT STE 200",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276156417",
"telephone_number": "919-389-9952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "154 MINE LAKE CT STE 200",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276156417",
"telephone_number": "919-389-9952"
}
],
"practiceLocations": [
{
"address_1": "8352 Six Forks Rd",
"address_2": "Suite 104",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276153054",
"country_code": "US",
"telephone_number": "919-782-8642",
"fax_number": "919-782-8642",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEEDS",
"first_name": "DEBRA",
"middle_name": "K",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-03",
"last_updated": "2019-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C005097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.