Individual provider Active NPI

Kathleen Leahy, LICSW

  • Clinical Social Worker
  • Cambridge, MA
National Provider Identifier
1912070640
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
102932 Issued in MA
Practice address
330 Mount Auburn St
Clark 1
Cambridge, MA 02138-5502
Phone
(617) 499-5054
Fax
(617) 499-5465
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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 102932 MA Primary

Addresses

Primary practice location

330 Mount Auburn St
Clark 1
Cambridge, MA 02138-5502

Mailing address

330 Mount Auburn St
Clark 1
Cambridge, MA 02138-5502
Phone (617) 499-5054

Other identifiers 1

IdentifierTypeStateIssuer
P02029OtherMABLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101229000032 MA Practitioner - Clinical Social Worker 2769670181 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Auburn Hospital CurrentSince Sep 30, 2010 Accepting new patients

Locations

330 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5054

330 Mount Auburn St
#1
Cambridge, MA 02138
Phone (617) 499-5054

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251849600000",
    "number": "1912070640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "address_2": "CLARK 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502",
            "telephone_number": "617-499-5054",
            "fax_number": "617-499-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "address_2": "CLARK 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502",
            "telephone_number": "617-499-5054",
            "fax_number": "617-499-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAHY",
        "first_name": "KATHLEEN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2009-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "102932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "P02029",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.