Individual provider Active NPI

Amanda Kathryn Leibenhaut, LMSW

  • Social Worker
  • New York, NY
National Provider Identifier
1861783508
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
082064-1 Issued in NY
Practice address
197 E Broadway
U3B
New York, NY 10002-5507
Phone
(212) 780-2300
Fax
(212) 529-0961
NPI assigned
Apr 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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 082064-1 NY Primary

Addresses

Primary practice location

197 E Broadway
U3B
New York, NY 10002-5507

Mailing address

197 E Broadway
U3B
New York, NY 10002-5507
Phone (212) 780-2300

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

LicenseStateTypeSpecialty
082064-1NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1303948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303948800000",
    "number": "1861783508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 E BROADWAY",
            "address_2": "U3B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100025507",
            "telephone_number": "212-780-2300",
            "fax_number": "212-529-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 E BROADWAY",
            "address_2": "U3B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100025507",
            "telephone_number": "212-780-2300",
            "fax_number": "212-529-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBENHAUT",
        "first_name": "AMANDA",
        "middle_name": "KATHRYN",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-28",
        "last_updated": "2011-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "082064-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.