Individual provider Active NPI

Nicholas Leeth, ED.D.

  • School Psychologist
  • Van Wert, OH
National Provider Identifier
1265261630
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
OH3280740 Issued in OH
Practice address
15945 Middle Point Rd
Van Wert, OH 45891-9769
Phone
(419) 968-2226
NPI assigned
Aug 1, 2024
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X OH3280740 OH Primary

Addresses

Primary practice location

15945 Middle Point Rd
Van Wert, OH 45891-9769

Mailing address

20530 Church Rd
Middle Point, OH 45863-9605
Phone (567) 259-9379

Other practice location 1

531 E Tully St
Convoy, OH 45832-8864
Phone (419) 749-9100

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
OH3280740OHMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Lincolnview Local School District PastSince Aug 4, 2024 Accepting new patients
Crestview Local School District 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.

NPI Registry JSON

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1265261630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20530 CHURCH RD",
            "city": "MIDDLE POINT",
            "state": "OH",
            "postal_code": "458639605",
            "telephone_number": "567-259-9379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15945 MIDDLE POINT RD",
            "city": "VAN WERT",
            "state": "OH",
            "postal_code": "458919769",
            "telephone_number": "419-968-2226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "531 E Tully St",
            "address_purpose": "LOCATION",
            "city": "Convoy",
            "state": "OH",
            "postal_code": "458328864",
            "country_code": "US",
            "telephone_number": "419-749-9100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEETH",
        "first_name": "NICHOLAS",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "OH3280740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Wert, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; 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.