Leah Grey Degrandis, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810005878 Issued in VA

Practice address

412 Chatham Square Office Park
Fredericksburg, VA 22405-2561

Phone

(540) 899-9826

Fax

(540) 373-3913

NPI assigned

Dec 30, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Health Resources PC

  • Clinical Social Worker
  • Fredericksburg, VA
  • NPI 1184714396
  NPD (past)

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

{
    "created_epoch": "1514592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514592000000",
    "number": "1124535059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 KARL LINN DR APT 421",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232256977",
            "telephone_number": "304-573-6062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 CHATHAM SQUARE OFFICE PARK",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052561",
            "telephone_number": "540-899-9826",
            "fax_number": "540-373-3913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRANDIS",
        "first_name": "LEAH",
        "middle_name": "GREY",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-30",
        "last_updated": "2017-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810005878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deeply Rooted Birth & Wellness Care
• Deeply Rooted Birth & Wellness Care LLC
• Frank D. Deforest, PH.D.
• Lema Seboka Degefa, MD
• Billiejo Degenkolb
• Peter Edwin Degraziano, O.D.
• Sisay Dejene, MD
• Briana Del Cid
• Diana Del Cid
• Jose Del Rosario

• Clinical Psychologist in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2017; 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.