Individual provider Active NPI

Leidy Johnson

  • Behavior Analyst
  • Clarks Summit, PA
National Provider Identifier
1255801650
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
1796 Newton Ransom Blvd
Clarks Summit, PA 18411-9610
Phone
(570) 520-8355
NPI assigned
Nov 28, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

1796 Newton Ransom Blvd
Clarks Summit, PA 18411-9610

Mailing address

1796 Newton Ransom Blvd
Clarks Summit, PA 18411-9610
Phone (570) 520-8355

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

NPI Registry JSON

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

{
    "created_epoch": "1543363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1255801650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1796 NEWTON RANSOM BLVD",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184119610",
            "telephone_number": "570-520-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1796 NEWTON RANSOM BLVD",
            "city": "CLARKS SUMMIT",
            "state": "PA",
            "postal_code": "184119610",
            "telephone_number": "570-520-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LEIDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-28",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarks Summit, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2018; 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.