Individual provider Active NPI

Leyla Mahbod-Kenny, L.I.C.S.W.

  • Clinical Social Worker
  • Washington, DC
National Provider Identifier
1891979860
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC3000857 Issued in DC
Practice address
1616 18TH St NW
Suite 112
Washington, DC 20009-2530
Phone
(202) 249-1163
NPI assigned
Dec 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC3000857 DC Primary

Addresses

Primary practice location

1616 18TH St NW
Suite 112
Washington, DC 20009-2530

Mailing address

1616 18TH St NW
Suite 112
Washington, DC 20009-2530
Phone (202) 249-1163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 1, 2016 through Apr 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC3000857DCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198627200000",
    "number": "1891979860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 18TH ST NW",
            "address_2": "SUITE 112",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092530",
            "telephone_number": "202-249-1163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 18TH ST NW",
            "address_2": "SUITE 112",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092530",
            "telephone_number": "202-249-1163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHBOD-KENNY",
        "first_name": "LEYLA",
        "name_prefix": "Dr.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC3000857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.