Individual provider Active NPI

Jill Van Leesten, LCSW

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1972218345
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW02835 Issued in RI
Practice address
460 Pine St
Providence, RI 02907-1358
Phone
(401) 274-9373
NPI assigned
Jan 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CSW02835 RI Primary

Addresses

Primary practice location

460 Pine St
Providence, RI 02907-1358

Mailing address

300 York Ave Apt 4
Pawtucket, RI 02860-5835
Phone (404) 964-3202

Other practice location 1

1540 Pontiac Ave
Cranston, RI 02920-4472
Phone (401) 781-7000 ext. 16

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSW02835RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Justice Assistance Single Specialty CurrentSince Jan 1, 2023 Accepting new patients
Amos House Single Specialty CurrentSince Apr 13, 2025 Accepting new patients
Amos House PastSince Apr 13, 2025 Accepting new patients

Locations

1540 Pontiac Ave
Cranston, RI 02920
Phone (401) 781-0537

Organizations & group practices 3

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": "1674086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1972218345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 YORK AVE APT 4",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605835",
            "telephone_number": "404-964-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 PINE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071358",
            "telephone_number": "401-274-9373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1540 Pontiac Ave",
            "address_purpose": "LOCATION",
            "city": "Cranston",
            "state": "RI",
            "postal_code": "029204472",
            "country_code": "US",
            "telephone_number": "401-781-7000 x16",
            "fax_number": "401-781-1062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN LEESTEN",
        "first_name": "JILL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-19",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "CSW02835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.