Organization Active NPI

Tami V Leonhardt PHD LLC

  • Clinical Psychologist
  • West Columbia, SC
National Provider Identifier
1184883787
Registry record updated Jun 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
560 Issued in SC
Legal business name
TAMI V LEONHARDT PHD LLC
Practice address
1904 Sunset Blvd
Suite D
West Columbia, SC 29169-5953
Phone
(803) 791-1485
Fax
(803) 939-9378
NPI assigned
Jun 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2008

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

Authorized official

Name
Dr. Tami V Leonhardt, PHD
Title
Owner
Phone
(803) 791-1485

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 560 SC Primary

Addresses

Primary practice location

1904 Sunset Blvd
Suite D
West Columbia, SC 29169-5953

Mailing address

1904 Sunset Blvd
Suite D
West Columbia, SC 29169-5953
Phone (803) 791-1485

Other identifiers 1

IdentifierTypeStateIssuer
PSO144MedicaidSC

National Provider Directory

National Provider Directory

Locations

1904 Sunset Blvd
Ste D
West Columbia, SC 29169
Phone (803) 791-1485

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212969600000",
    "number": "1184883787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 SUNSET BLVD",
            "address_2": "SUITE D",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291695953",
            "telephone_number": "803-791-1485",
            "fax_number": "803-939-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 SUNSET BLVD",
            "address_2": "SUITE D",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291695953",
            "telephone_number": "803-791-1485",
            "fax_number": "803-939-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMI V LEONHARDT PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2008-06-09",
        "status": "A",
        "authorized_official_last_name": "LEONHARDT",
        "authorized_official_first_name": "TAMI",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-791-1485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PSO144",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; 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.