Active NPI
Mary Denise Leroy, LPC, NCC
- Professional Counselor
- Salem, OR
National Provider Identifier
1033491808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 4148
- Practice address
- 3750 Chemawa Rd NE
Salem, OR 97305-1111 - Phone
- (503) 304-7600
- Fax
- (503) 304-7678
- NPI assigned
- Sep 16, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 4148 | OK | Primary |
Addresses
Primary practice location
3750 Chemawa Rd NE
Salem, OR 97305-1111
Mailing address
3750 Chemawa Rd NE
Salem, OR 97305-1111
Phone (503) 304-7600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2003
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
448 36TH Ave NW
Suite 101
Norman, OK 73072-4743
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4148 | OK | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millennium Medical Services, L.L.C. | Professional | Current | Accepting new patients |
Locations
448 36th Ave NW
Ste 101
Norman, OK 73072
Phone (405) 623-1624
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350345600000",
"number": "1033491808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3750 CHEMAWA RD NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973051111",
"telephone_number": "503-304-7600",
"fax_number": "503-304-7678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3750 CHEMAWA RD NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973051111",
"telephone_number": "503-304-7600",
"fax_number": "503-304-7678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEROY",
"first_name": "MARY",
"middle_name": "DENISE",
"name_prefix": "Ms.",
"credential": "LPC, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-16",
"last_updated": "2012-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OK",
"license": "4148",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.