Individual provider Active NPI

Kathryn Keleen Leasure, PHD

  • Psychologist
  • Tallahassee, FL
National Provider Identifier
1205556396
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY11520 Issued in FL
Practice address
267 John Knox Rd Ste 114
Tallahassee, FL 32303-6628
Phone
(850) 807-9801
NPI assigned
Aug 30, 2022
Last updated
Aug 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY11520 FL Primary

Addresses

Primary practice location

267 John Knox Rd Ste 114
Tallahassee, FL 32303-6628

Mailing address

192 Parkbrook Cir
Tallahassee, FL 32301-8915
Phone (850) 290-4052

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL drleasure@drpowerstherapy.com

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY11520FLMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1205556396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 PARKBROOK CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323018915",
            "telephone_number": "850-290-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 JOHN KNOX RD STE 114",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323036628",
            "telephone_number": "850-807-9801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEASURE",
        "first_name": "KATHRYN",
        "middle_name": "KELEEN",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY11520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "drleasure@drpowerstherapy.com",
            "affiliation": "N",
            "address_1": "267 John Knox Rd Ste 114",
            "city": "Tallahassee",
            "state": "FL",
            "country_code": "US",
            "postal_code": "323036628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.