Active NPI
Marianna Leavy-Sperounis, PSY.D.
- Psychologist
- Cambridge, MA
National Provider Identifier
1083146179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 11413
- Practice address
- 12 Arrow St Ste 210
Cambridge, MA 02138-5105 - Phone
- (617) 682-0646
- NPI assigned
- Mar 29, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 11413 | MA | Primary |
Addresses
Primary practice location
12 Arrow St Ste 210
Cambridge, MA 02138-5105
Mailing address
7 Camden PL
Cambridge, MA 02138-4705
Phone (617) 682-0646
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 Sep 26, 2022 through Sep 26, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11413 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1083146179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 CAMDEN PL",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021384705",
"telephone_number": "617-682-0646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 ARROW ST STE 210",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021385105",
"telephone_number": "617-682-0646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAVY-SPEROUNIS",
"first_name": "MARIANNA",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-29",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MA",
"license": "11413",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.