Individual provider Active NPI

Leyla Mansur

  • Clinical Psychologist
  • Columbia, MD
National Provider Identifier
1255004859
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
06467 Issued in MD
Practice address
10025 Governor Warfield Pkwy Ste 209B
Columbia, MD 21044-3340
Phone
(410) 541-1250
NPI assigned
Jul 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 06467 MD Primary

Addresses

Primary practice location

10025 Governor Warfield Pkwy Ste 209B
Columbia, MD 21044-3340

Mailing address

10025 Governor Warfield Pkwy Ste 209B
Columbia, MD 21044-3340
Phone (410) 541-1250

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

State licenses

LicenseStateTypeSpecialty
06467MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1255004859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10025 GOVERNOR WARFIELD PKWY STE 209B",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443340",
            "telephone_number": "410-541-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10025 GOVERNOR WARFIELD PKWY STE 209B",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443340",
            "telephone_number": "410-541-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSUR",
        "first_name": "LEYLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "06467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.