Dennis Keith Leisenring, PSY D

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

000144 Issued in VT

Practice address

234 Maple St
Box 849
Stowe, VT 05672-4248

Phone

(802) 253-7337

Fax

(802) 253-7332

NPI assigned

Mar 25, 2007

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013034826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "166 GOLD BROOK CIR",
            "city": "STOWE",
            "state": "VT",
            "postal_code": "056724535",
            "telephone_number": "802-253-8498",
            "fax_number": "802-253-7332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 MAPLE ST",
            "address_2": "BOX 849",
            "city": "STOWE",
            "state": "VT",
            "postal_code": "056724248",
            "telephone_number": "802-253-7337",
            "fax_number": "802-253-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEISENRING",
        "first_name": "DENNIS",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PSY D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "000144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.