Individual provider Active NPI

Mary Denise Leroy, LPC, NCC

  • Professional Counselor
  • Salem, OR
National Provider Identifier
1033491808
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4148 Issued in OK
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

Updated by the provider on Oct 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250923000394 OK Practitioner - Mental Health Counselor 8820593874 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
4148OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Medical Services, L.L.C. Professional CurrentSince Sep 1, 2025 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

Verify at the official NPI Registry.