Individual provider Active NPI

Janice Leeds, PH.D.

  • Psychologist
  • Warren, NJ
National Provider Identifier
1023037595
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2957 Issued in NJ
Practice address
9 Mustang TRL
Warren, NJ 07059-6914
Phone
(732) 764-0289
Fax
(732) 764-0265
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2957 NJ Primary

Addresses

Primary practice location

9 Mustang TRL
Warren, NJ 07059-6914

Mailing address

9 Mustang TRL
Warren, NJ 07059-6914
Phone (732) 764-0289

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2957NJMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023037595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MUSTANG TRL",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070596914",
            "telephone_number": "732-764-0289",
            "fax_number": "732-764-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MUSTANG TRL",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070596914",
            "telephone_number": "732-764-0289",
            "fax_number": "732-764-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEDS",
        "first_name": "JANICE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "2957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, NJ

Sources for this page

Verify at the official NPI Registry.