Leigh Dexter Tuttle, PH.D.

Individual provider Active NPI Clinical Social Worker · Bolton, MA

NPI 1992811624 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1992811624
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
1015358 (MA)
Practice address
563 Main St
Bolton, MA 01740-1300
Phone
(978) 779-0211
Fax
(978) 779-0211
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

563 Main St
Bolton, MA 01740-1300
Phone (978) 779-0211

PO Box
Suite 576
Bolton, MA 01740-0576

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040519000747 MA Practitioner - Clinical Social Worker 8224029202 Practice locations: Bolton, MA

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Philosophy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1015358 MA Yes

Addresses

Primary practice location

563 Main St
Bolton, MA 01740-1300

Mailing address

563 Main St
Bolton, MA 01740-1300
Phone (978) 779-0211

Other providers in Bolton, MA

All providers in Bolton, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.