Individual provider Active NPI

Kayla Aubrey Lord Leeshock, PH.D.

  • Clinical Psychologist
  • Hartford, CT
National Provider Identifier
1285228627
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4558 Issued in CT
Practice address
200 Retreat Ave
Hartford, CT 06106-3309
Phone
(860) 545-7685
NPI assigned
Feb 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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 4558 CT Primary

Addresses

Primary practice location

200 Retreat Ave
Hartford, CT 06106-3309

Mailing address

200 Retreat Ave
Hartford, CT 06106-3309
Phone (860) 545-7685

Other practice location 1

680 S Main St
Cheshire, CT 06410-3181
Phone (203) 699-2030

Other names 1

  • Dr. Kayla Aubrey Lord Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230818003154 CT Practitioner - Clinical Psychologist 6800258047 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hartford HospitalGroup PAC ID 2567366016, shared by 6 NPIs, 1,040 clinicians

Practice addresses (Care Compare)

200 Retreat Ave
Hartford, CT 06106-3310
Phone (860) 545-7500

680 S Main St
Hartford Hospital Anxiety Disorders
Cheshire, CT 06410-3181
Phone (203) 699-2030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.63 of 100Reported as group
Quality
75.35
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
004558CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Hospital CurrentSince Aug 14, 2023 Accepting new patients
Hartford Hospital CurrentSince Aug 14, 2023 Accepting new patients
Hartford Hospital CurrentSince Aug 14, 2023 Accepting new patients

Locations

680 S Main St
Cheshire, CT 06410
Phone (203) 272-3595

200 Retreat Ave
Hartford, CT 06106
Phone (860) 545-7000

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1614211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1285228627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063309",
            "telephone_number": "860-545-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 RETREAT AVE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061063309",
            "telephone_number": "860-545-7685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 S Main St",
            "address_purpose": "LOCATION",
            "city": "Cheshire",
            "state": "CT",
            "postal_code": "064103181",
            "country_code": "US",
            "telephone_number": "203-699-2030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LORD LEESHOCK",
        "first_name": "KAYLA",
        "middle_name": "AUBREY",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-25",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "4558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "LORD",
            "middle_name": "AUBREY",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hartford, CT

Sources for this page

Verify at the official NPI Registry.