Individual provider Active NPI

Janis Leigh, PSY.D.

  • Psychologist
  • Terre Haute, IN
National Provider Identifier
1164702452
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
990047660A Issued in IN
Practice address
Indiana State University Psycholog Clinic
Root Hall
Terre Haute, IN 47809-0001
Phone
(812) 237-3317
Fax
(812) 237-4378
NPI assigned
Aug 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 990047660A IN Primary

Addresses

Primary practice location

Indiana State University Psycholog Clinic
Root Hall
Terre Haute, IN 47809-0001

Mailing address

709 S Forest Dr
Terre Haute, IN 47803-4222
Phone (812) 237-3447

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

LicenseStateTypeSpecialty
990047660AINMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana State University Past Accepting new patients
Indiana State University 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313625600000",
    "number": "1164702452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 S FOREST DR",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478034222",
            "telephone_number": "812-237-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "INDIANA STATE UNIVERSITY PSYCHOLOG CLINIC",
            "address_2": "ROOT HALL",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478090001",
            "telephone_number": "812-237-3317",
            "fax_number": "812-237-4378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIGH",
        "first_name": "JANIS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "990047660A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Terre Haute, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.