Leah Jean Clark, LMSW
Individual provider Active NPI Social Worker · Ankeny, IA
NPI 1972158137 · NPPES record last updated Aug 5, 2019
Key facts
- NPI
- 1972158137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 06723 (IA)
- Practice address
- 910 NE 5TH St
Ankeny, IA 50021-4721 - Phone
- (319) 239-8831
- NPI assigned
- Aug 5, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06723 | IA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ujima Community Services | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 06723 | IA | Yes |
Addresses
Primary practice location
910 NE 5TH St
Ankeny, IA 50021-4721
Mailing address
910 NE 5TH St
Ankeny, IA 50021-4721
Phone (319) 239-8831
Other providers in Ankeny, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2019. 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.