Leslie W. Green, PHD, P.C.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LESLIE W. GREEN, PHD, P.C.

Practice address

1740 W Big Beaver Rd Ste 206
Troy, MI 48084-3507

Phone

(248) 593-0678

NPI assigned

Apr 15, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Leslie W Green, PH.D.NPI 1073646774

Title

President

Phone

(248) 765-8366

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leslie Weiss Green, PH.D.

  • Psychologist
  • Troy, MI
  • NPI 1073646774
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1174266373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1563",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480991563",
            "telephone_number": "248-765-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W BIG BEAVER RD STE 206",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843507",
            "telephone_number": "248-593-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE W. GREEN, PHD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-15",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-765-8366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Lempert Lepsetz, LMSW
• Lequishia Alexander MD PLLC
• Austin Thomas Leske, DDS
• Chase Martin-Gabriel Leske, DDS
• Daniel Leske, D.D.S.
• Jessica Leann Lesperance, OTR/L
• Tishayla Lareese Lester
• Simona Leonidovna Leszinsky, PA-C
• Lets Talk Therapy PLC
• Melanie Lett

• Mental Health Clinic/Center (Including Community Mental Health Center) in Troy, MI
• Providers in Troy, MI by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.