Melissa Jean Leedy, PHD

Primary specialty

Health Service PsychologistTaxonomy code 103TH0100X

License

1268 Issued in OK

Practice address

2035A West Houston Street
Broken Arrow, OK 74012-8792

Phone

(918) 505-4367

Fax

(888) 371-9410

NPI assigned

Jan 20, 2009

Last updated

Sep 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Oct 1, 2024 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Legacy Counseling Service

  dba Melissa Leedy, Ph.D.

  • Psychologist
  • Broken Arrow, OK
  • NPI 1205377678
  NPD Authorized official

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1194962720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035A WEST HOUSTON STREET",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128792",
            "telephone_number": "918-505-4367",
            "fax_number": "888-371-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2035A WEST HOUSTON STREET",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740128792",
            "telephone_number": "918-505-4367",
            "fax_number": "888-371-9410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2498 W New Orleans St",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740111590",
            "country_code": "US",
            "telephone_number": "539-777-1129",
            "fax_number": "888-371-9410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEEDY",
        "first_name": "MELISSA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-20",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 7846",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "OK",
            "license": "1268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Renee' Lee, M.D.
• John Robert Lee, PHARM.D.
• Lisa Jo Lee
• Mary Lee
• Rhonda Kay Lee
• Edith Maria Leerdam
• Legacy Counseling Service (Melissa Leedy, Ph.D.)
• Valorie K Lehman
• Josh Lemery
• Neisha R. Lemier, M.S., CCC-SLP

• Health Service Psychologist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Health Service Psychologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.