Active NPI
Bennett Leslie, PSYD
- Psychologist
- Aurora, CO
National Provider Identifier
1053367581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 2502
- Practice address
- 1635 Ursula St
Suite # 5501
Aurora, CO 80010-7402 - Phone
- (720) 848-1090
- Fax
- (720) 848-1277
- NPI assigned
- May 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 2502 | CO | Primary |
Addresses
Primary practice location
1635 Ursula St
Suite # 5501
Aurora, CO 80010-7402
Mailing address
PO Box 6503
Integrative Medicine Program
Aurora, CO 80045-0503
Phone (303) 724-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33739889 | Medicaid | CO |
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: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2018 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2502 | CO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148601600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1053367581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6503",
"address_2": "INTEGRATIVE MEDICINE PROGRAM",
"city": "AURORA",
"state": "CO",
"postal_code": "800450503",
"telephone_number": "303-724-5000",
"fax_number": "303-724-5816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 URSULA ST",
"address_2": "SUITE # 5501",
"city": "AURORA",
"state": "CO",
"postal_code": "800107402",
"telephone_number": "720-848-1090",
"fax_number": "720-848-1277"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LESLIE",
"first_name": "BENNETT",
"name_prefix": "Mr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-26",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "2502",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "33739889",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.