Leland W. Petersen, Psychologist, P.C.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05430 Issued in NY

Legal business name

LELAND W. PETERSEN, PSYCHOLOGIST, P.C.

Practice address

11 Beechwood Dr
Glen Head, NY 11545-1101

Phone

(516) 671-7509

NPI assigned

Apr 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Leland Walter Petersen, PH.D.

Title

President

Phone

(516) 671-7509

Specialties & licenses 1

Addresses

Other names 1

• L.W. Petersen, Psychologist, P.C. Other name

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1083831408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 BEECHWOOD DR",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451101",
            "telephone_number": "516-671-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BEECHWOOD DR",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "115451101",
            "telephone_number": "516-671-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LELAND W. PETERSEN, PSYCHOLOGIST, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "LELAND",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-671-7509",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "05430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "L.W. Petersen, Psychologist, P.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nancy H Larson, ANP
• Christine Lau, MS CCC-SLP
• Susan Laudisio, MS CCC-SLP
• Margaret H. Lavi Deo, S.L.P.
• Lawrence J. Robinson, MD., P.C.
• Alyson Lewis-Anner, LCSW
• Jaclyn Liang, RPH
• Lillys Fine Lingerie, Inc.
• Linda S. Lamarca, PH.D.
• Samantha Sasha Lindo, FNP

• Clinical Psychologist in Glen Head, NY
• Providers in Glen Head, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.