Active NPI
Leah Shavalier, PSYD
- Psychologist
- Wilmington, NC
National Provider Identifier
1063720779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS01773
- Practice address
- 3807 Wrightsville Ave Ste 21
Wilmington, NC 28403-8463 - Phone
- (716) 725-5805
- NPI assigned
- Sep 15, 2010
- Last updated
- Dec 18, 2023
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS01773 | RI | Primary |
Addresses
Primary practice location
3807 Wrightsville Ave Ste 21
Wilmington, NC 28403-8463
Mailing address
3807 Wrightsville Ave Ste 21
Wilmington, NC 28403-8463
Phone (910) 418-1653
Other names 1
- Leah Obertean
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 16, 2025 through Jul 16, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS01773 | RI | MD | Psychologist |
| 6001 | NC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702857600000",
"number": "1063720779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3807 WRIGHTSVILLE AVE STE 21",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284038463",
"telephone_number": "910-418-1653",
"fax_number": "910-218-8347"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3807 WRIGHTSVILLE AVE STE 21",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284038463",
"telephone_number": "716-725-5805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAVALIER",
"first_name": "LEAH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-15",
"last_updated": "2023-12-18",
"certification_date": "2023-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "RI",
"license": "PS01773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LEAH",
"last_name": "OBERTEAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wilmington, NC
- Phillip M. Sharp, ED.D.,
- Hannah Sharpe, PHARMD
- Teddi Jo Sharpton, BA, LMBT
- Colleen Mary Shaughnessy, NURSE PRACTITIONER
- Michael Reilly Shaughnessy, MD
- Shaver Chiropractic (Shaver Chiropractic & Natural Medicine Office, PA)
- Raymond Todd Shaver, DC DICCP
- Ashley Shaw
- Charles Thomas Shaw, PHARMD
- David Lawrence Shaw, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.