Active NPI
Leslie A Blanchard, PH.D.
- Psychologist
- Russellville, AR
National Provider Identifier
1154579902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 09-16P
- Practice address
- 3101 West 2ND CT
Russellville, AR 72801 - Phone
- (479) 567-5654
- Fax
- (479) 567-5661
- NPI assigned
- Sep 5, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 07-7E | AR | |
| Psychologist | 103T00000X | 09-16P | AR | Primary |
Addresses
Primary practice location
3101 West 2ND CT
Russellville, AR 72801
Mailing address
P.O. Box 10323
Russellville, AR 72812
Phone (479) 567-5654
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09-16P | AR | MD | Psychologist |
| 07-7E | AR | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| River Valley Psychology PLLC | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychologist
- Russellville, AR
- NPI 1235424326
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1220572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515369600000",
"number": "1154579902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 10323",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "72812",
"telephone_number": "479-567-5654",
"fax_number": "479-567-5661"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 WEST 2ND CT",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "72801",
"telephone_number": "479-567-5654",
"fax_number": "479-567-5661"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANCHARD",
"first_name": "LESLIE",
"middle_name": "A",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-05",
"last_updated": "2018-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AR",
"license": "07-7E",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AR",
"license": "09-16P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Russellville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.