Healthcare Provider Details

I. General information

NPI: 1861383903
Provider Name (Legal Business Name): VANESSA AMERICA LEYVA MSW, LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 ROCKFORD ST
MOUNT AIRY NC
27030-5323
US

IV. Provider business mailing address

PO BOX 1490
BOONE NC
28607-0682
US

V. Phone/Fax

Practice location:
  • Phone: 336-789-5058
  • Fax:
Mailing address:
  • Phone: 828-262-3886
  • Fax: 828-265-4816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP022523
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: