Active NPI
Kimberly A. G. Leichty, LPCC
- Professional Counselor
- Urbana, OH
National Provider Identifier
1255769394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- C.1100103-CR
- Practice address
- 1522 East US Rte 36
Suite a
Urbana, OH 43078 - Phone
- (937) 653-5583
- Fax
- (937) 653-4787
- NPI assigned
- Oct 29, 2013
- Last updated
- Jan 25, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E100103 | OH | |
| School Counselor | 101YS0200X | OH 3092026 | OH | |
| Professional Counselor | 101YP2500X | C.1100103-CR | OH | Primary |
Addresses
Primary practice location
1522 East US Rte 36
Suite a
Urbana, OH 43078
Mailing address
PO Box 817
West Liberty, OH 43357-0817
Phone (937) 465-8065
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
| License | State | Type | Specialty |
|---|---|---|---|
| C.1100103-CR | OH | MD | Professional Counselor |
| E100103 | OH | MD | Professional Counselor |
| OH 3092026 | OH | MD | School Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Consolidated Care Inc | Past | Accepting new patients | |
| TCN Behavioral Health Services, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Counselor
- West Liberty, OH
- NPI 1215933569
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Xenia, OH
- NPI 1336118256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485302400000",
"number": "1255769394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 817",
"city": "WEST LIBERTY",
"state": "OH",
"postal_code": "433570817",
"telephone_number": "937-465-8065",
"fax_number": "937-465-0442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1522 EAST US RTE 36",
"address_2": "SUITE A",
"city": "URBANA",
"state": "OH",
"postal_code": "43078",
"telephone_number": "937-653-5583",
"fax_number": "937-653-4787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEICHTY",
"first_name": "KIMBERLY",
"middle_name": "A. G.",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-10-29",
"last_updated": "2017-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E100103",
"primary": false
},
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "OH",
"license": "OH 3092026",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "C.1100103-CR",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Urbana, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.