Linda L Leavens, RN, LCSW, CASAC
Individual provider Active NPI Clinical Social Worker · Ticonderoga, NY
NPI 1962776153 · NPPES record last updated Nov 30, 2012
Key facts
- NPI
- 1962776153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 080134-1 (NY)
- Practice address
- 166 Lord Howe St.
Ticonderoga, NY 12883 - Phone
- (518) 586-6568
- Fax
- (518) 585-3265
- NPI assigned
- Mar 6, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16940 | NY | MD | Addiction (Substance Use Disorder) Counselor |
| 068145-1 | NY | MD | Social Worker |
| 080134-1 | NY | MD | Clinical Social Worker |
| 362081-1 | NY | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16940 | NY | |
| Social Worker | 104100000X | 068145-1 | NY | |
| Registered Nurse | 163W00000X | 362081-1 | NY | |
| Clinical Social Worker | 1041C0700X | 080134-1 | NY | Yes |
Addresses
Primary practice location
166 Lord Howe St.
Ticonderoga, NY 12883
Mailing address
166 Lord Howe St.
Ticonderoga, NY 12883
Phone (518) 586-6568
Other providers in Ticonderoga, NY
- Anne Kuhl
- Lacey J Lacourse
- Amy Lapierre
- Sarah Jane Lapointe
- Renee Katherine Larock-Gary
- Susan B Malaney
- Prashant Malhotra
- Richard N McKeever
- Robert Thomas McLaughlin
- Patricia M McLoughlin
All providers in Ticonderoga, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.