Active NPI
Jennifer Leslie, PSY.D
- Clinical Psychologist
- Woburn, MA
National Provider Identifier
1114276524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 10371
- Practice address
- 12 Alfred Street
Suite 200
Woburn, MA 01801 - Phone
- (781) 646-0500
- NPI assigned
- Aug 30, 2012
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 10371 | MA | Primary |
Addresses
Primary practice location
12 Alfred Street
Suite 200
Woburn, MA 01801
Mailing address
12 Alfred Street
Suite 200
Woburn, MA 01801
Phone (781) 646-0500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10371 | MA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jennifer Leslie PSYD LLC | Current | Accepting new patients | |
| Child and Family Psychological Services, PLLC | Clinical | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466035200000",
"number": "1114276524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 ALFRED STREET",
"address_2": "SUITE 200",
"city": "WOBURN",
"state": "MA",
"postal_code": "01801",
"telephone_number": "781-646-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 ALFRED STREET",
"address_2": "SUITE 200",
"city": "WOBURN",
"state": "MA",
"postal_code": "01801",
"telephone_number": "781-646-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LESLIE",
"first_name": "JENNIFER",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-30",
"last_updated": "2016-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "10371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.