NPIMap

Organization Active NPI

Legacy Counseling Service

Doing business as Melissa Leedy, Ph.D.

  • Psychologist
  • Broken Arrow, OK
National Provider Identifier
1205377678
Registry record updated Sep 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1268 Issued in OK
Legal business name
LEGACY COUNSELING SERVICE
Doing business as
Melissa Leedy, Ph.D.
Practice address
2035A West Houston Street
Broken Arrow, OK 74012-8792
Phone
(918) 505-4367
Fax
(888) 371-9410
NPI assigned
Mar 17, 2017
Last updated
Sep 4, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2022

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

Authorized official

Name
Dr. Melissa Jean Leedy, PH.D.NPI 1194962720
Title
Owner/Opertor
Phone
(918) 505-4367

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1268 OK Primary

Addresses

Primary practice location

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

Mailing address

6406 E Fort Worth PL
Broken Arrow, OK 74014-7043
Phone (918) 505-4367

Other names 1

  • Melissa Leedy, Ph.D. Doing business as

National Provider Directory

National Provider Directory

Locations

2498 W New Orleans St
Broken Arrow, OK 74011
Phone (539) 777-1129

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662249600000",
    "number": "1205377678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6406 E FORT WORTH PL",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740147043",
            "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": [],
    "basic": {
        "organization_name": "LEGACY COUNSELING SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-17",
        "last_updated": "2022-09-04",
        "certification_date": "2022-09-04",
        "status": "A",
        "authorized_official_last_name": "LEEDY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER/OPERTOR",
        "authorized_official_telephone_number": "918-505-4367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OK",
            "license": "1268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melissa Leedy, Ph.D.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Melissa Leedy, Ph.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2022; 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.