Active NPI
Leslie A. Gibson, PH.D.
- Clinical Psychologist
- Ardsley, NY
National Provider Identifier
1043435720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 014201-1
- Practice address
- 547 Saw Mill River Rd Ste 1F1
Ardsley, NY 10502-2143 - Phone
- (914) 478-2128
- NPI assigned
- Apr 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 014201-1 | NY | |
| Clinical Psychologist | 103TC0700X | 014201-1 | NY | Primary |
Addresses
Primary practice location
547 Saw Mill River Rd Ste 1F1
Ardsley, NY 10502-2143
Mailing address
547 Saw Mill River Rd Ste 1F1
Ardsley, NY 10502-2143
Phone (914) 478-2128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014201-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622764800000",
"number": "1043435720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "547 SAW MILL RIVER RD STE 1F1",
"city": "ARDSLEY",
"state": "NY",
"postal_code": "105022143",
"telephone_number": "914-478-2128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "547 SAW MILL RIVER RD STE 1F1",
"city": "ARDSLEY",
"state": "NY",
"postal_code": "105022143",
"telephone_number": "914-478-2128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "LESLIE",
"middle_name": "A.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2021-06-04",
"certification_date": "2021-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NY",
"license": "014201-1",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "014201-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ardsley, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.