Individual provider Active NPI

Timothy J Leary, MSW

  • Clinical Social Worker
  • Overland Park, KS
National Provider Identifier
1962520916
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSCSW 1532 Issued in KS
Practice address
10551 Barkley St Ste 512
Overland Park, KS 66212-1813
Phone
(913) 205-7049
Fax
(913) 317-8193
NPI assigned
Mar 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LSCSW 1532 KS Primary
Clinical Social Worker 1041C0700X LCSW 0004247 MO

Addresses

Primary practice location

10551 Barkley St Ste 512
Overland Park, KS 66212-1813

Mailing address

PO Box 9233
Shawnee Mission, KS 66201-1833
Phone (913) 205-7049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20141120001482 KS Practitioner - Clinical Social Worker 1557583879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4121 W 83Rd St
Suite 204
Prairie Village, KS 66208-5323
Phone (913) 205-7049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1532KSMDSocial Worker
LSCSW 1532KSMDClinical Social Worker
LCSW 0004247MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy Leary & Associates, LLC Clinical CurrentSince Dec 19, 2006 Accepting new patients

Locations

10551 Barkley St
Ste 512
Overland Park, KS 66212
Phone (913) 205-7049

4121 W 83rd St
Ste 204
Prairie Vlg, KS 66208
Phone (913) 205-7049

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1962520916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9233",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662011833",
            "telephone_number": "913-205-7049",
            "fax_number": "913-341-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10551 BARKLEY ST STE 512",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662121813",
            "telephone_number": "913-205-7049",
            "fax_number": "913-317-8193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEARY",
        "first_name": "TIMOTHY",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "LSCSW 1532",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "LCSW 0004247",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.