LEISHA R RISTAU LISW
NPI 1104172980
Social Worker - Clinical in Ankeny, IA

Q: What is Leisha Ristau's NPI number?

The NPI number for Leisha Ristau is 1104172980. It was assigned to this individual provider in the NPPES registry on July 30, 2012. The provider is also known as Leisha R Staples Lisw.

Q: What is Leisha Ristau's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: Is Leisha Ristau enrolled in Medicare?

No. Leisha Ristau has opted out of Medicare through October 10, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Leisha Ristau was last updated on February 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 30, 2012Opted out of Medicare · through Oct 10, 2026

2425 N ANKENY BLVD STE 106, ANKENY, IA 50023(515) 489-4602(515) 512-1504 Get Directions Write a Review

NPPES record last updated: February 27, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 10, 2023, Nov 26, 2023, Jan 10, 2017 (3 updates tracked since 2017).

On this page

About Leisha R Ristau Lisw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEISHA R RISTAU LISW (NPI 1104172980) is an individual clinical provider in Ankeny, Iowa, licensed in Iowa (007931) and active in the NPI registry since July 2012. She has opted out of Medicare through October 10, 2026 and maintains a secondary practice location in Ankeny.

NPPES Registry Identity

NPI1104172980

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameLEISHA R RISTAUCredential: LISW

Location Address2425 N ANKENY BLVD STE 106Ankeny, IA 50023-4722

Mailing Address2425 N Ankeny Blvd Ste 106Ankeny, IA 50023-4711 · (515) 489-4602

Phone(515) 489-4602

Fax(515) 512-1504

Sole ProprietorNo

Enumeration DateJuly 30, 2012

Last NPPES UpdateFebruary 27, 20243 updates tracked since enumeration

NPPES CertifiedFebruary 27, 2024

✔ NPI 1104172980 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in IA · 007931

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

2425 N ANKENY BLVD STE 106, Ankeny, IA 50023

Open in Google Maps ↗

Other Names 1

Former Name (1)Leisha R Staples Lisw

Secondary Practice Location 1

Location 11116 SE Mill Pond CtAnkeny, IA 50021-6533 · Phone (515) 489-4602 · Fax (515) 512-1504

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Leisha R Ristau Lisw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 10, 2016 through October 10, 2026.

Opt-Out Effective DateOctober 10, 2016

Opt-Out In Effect ThroughOctober 10, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MOLLY JANE RIORDAN LMHC

Counselor (Mental Health)