Leistikowmd LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LEISTIKOWMD LLC

Practice address

600 Wyndhurst Ave Ste 305E
Baltimore, MD 21210-2489

Phone

(443) 459-1840

NPI assigned

Apr 2, 2021

Organization subpart

No

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

Authorized official

Name

Nicole Leistikow, MDNPI 1861784118

Title

Owner

Phone

(443) 799-9384

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Leistikow, M.D.

  • Psychiatry Physician
  • Baltimore, MD
  • NPI 1861784118
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1285213843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WYNDHURST AVE STE 305E",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212102489",
            "telephone_number": "443-799-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 WYNDHURST AVE STE 305E",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212102489",
            "telephone_number": "443-459-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEISTIKOWMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-02",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "LEISTIKOW",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-799-9384",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Irene Leinbach, DMD, MPH
• Alison Leiner, L.AC
• Michele Marie Leisher, LCSW-C
• Della Leister, R.N.
• Nicole Leistikow, M.D.
• Guilherme Leite Barboza Goncalves, MD
• Jeffrey Adam Leiter, M.D.
• Nikita Leiter, MD
• Adrianna Leith
• Amy L Leitzel, CNM

• Adult Mental Health Clinic/Center in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Adult Mental Health Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.