Active NPI
Carol A. Leavell, PH.D.
- Clinical Neuropsychologist
- Braintree, MA
National Provider Identifier
1205809902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 4712
- Practice address
- 250 Pond St
Braintree, MA 02184-5351 - Phone
- (781) 348-2218
- Fax
- (781) 348-2132
- NPI assigned
- Feb 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 4712 | MA | Primary |
Addresses
Primary practice location
250 Pond St
Braintree, MA 02184-5351
Mailing address
250 Pond St
Braintree, MA 02184-5351
Phone (781) 348-2218
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| WO 5654 | Other | MA | BC/BS |
| 0500780 | Medicaid | MA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1205809902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 POND ST",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "021845351",
"telephone_number": "781-348-2218",
"fax_number": "781-348-2132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 POND ST",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "021845351",
"telephone_number": "781-348-2218",
"fax_number": "781-348-2132"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAVELL",
"first_name": "CAROL",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-12",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "MA",
"license": "4712",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "WO 5654",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0500780",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Braintree, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.