Perez Neuropsychology

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PEREZ NEUROPSYCHOLOGY

Practice address

2355 Highway 36 W Ste 400
Roseville, MN 55113-3905

Phone

(612) 460-1597

Fax

(855) 708-5583

NPI assigned

Feb 26, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Leslie N Perez, PSYD, ABPP-CNNPI 1104476589

Title

Board-Certified Neuropsychologist

Phone

(612) 460-1597

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leslie N Perez, PSYD, LP

  • Clinical Neuropsychologist
  • Minneapolis, MN
  • NPI 1104476589
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760054400000",
    "number": "1073379293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 400",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "612-460-1597",
            "fax_number": "855-708-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W STE 400",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133905",
            "telephone_number": "612-460-1597",
            "fax_number": "855-708-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEREZ NEUROPSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "BOARD-CERTIFIED NEUROPSYCHOLOGIST",
        "authorized_official_telephone_number": "612-460-1597",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, ABPP-CN"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Andrea Leigh Petersen

• Clinical Psychologist in Roseville, MN
• Providers in Roseville, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.