Active NPI
Leon J Monnin, PHD
- Psychologist
- Brockton, MA
National Provider Identifier
1013015296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3820
- Practice address
- 1350 Belmont Street
Suite 103
Brockton, MA 02301-4430 - Phone
- (508) 580-2137
- Fax
- (508) 559-6143
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3820 | MA | Primary |
Addresses
Primary practice location
1350 Belmont Street
Suite 103
Brockton, MA 02301-4430
Mailing address
1350 Belmont Street
Suite 103
Brockton, MA 02301-4430
Phone (508) 580-2137
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0517496 | Medicaid | MA | |
| 406936 | Other | MA | TAHP |
| W03823 | Other | MA | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040915000538 | MA | Practitioner - Clinical Psychologist | 8527035864 | Practice locations: Brockton, MA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3820 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013015296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 BELMONT STREET",
"address_2": "SUITE 103",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023014430",
"telephone_number": "508-580-2137",
"fax_number": "508-559-6143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1350 BELMONT STREET",
"address_2": "SUITE 103",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023014430",
"telephone_number": "508-580-2137",
"fax_number": "508-559-6143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONNIN",
"first_name": "LEON",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "3820",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0517496",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAHP",
"identifier": "406936",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "W03823",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.