Individual provider Active NPI

Leanne Carlson, PHD HSPP

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1295735744
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20040653A Issued in IN
Practice address
50 E 91St St
Ste 208
Indianapolis, IN 46240
Phone
(317) 431-0897
Fax
(317) 598-0355
NPI assigned
Jul 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 20040653A IN Primary

Addresses

Primary practice location

50 E 91St St
Ste 208
Indianapolis, IN 46240

Mailing address

50 E 91St St
Ste 208
Indianapolis, IN 46240
Phone (317) 431-0897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20150317000361 IN Practitioner - Clinical Psychologist 7113021015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8395 Keystone Xing
Suite 104
Indianapolis, IN 46240-2489
Phone (317) 431-0897

National Provider Directory

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1122422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295735744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E 91ST ST",
            "address_2": "STE 208",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46240",
            "telephone_number": "317-431-0897",
            "fax_number": "317-598-0355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 E 91ST ST",
            "address_2": "STE 208",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46240",
            "telephone_number": "317-431-0897",
            "fax_number": "317-598-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "LEANNE",
        "name_prefix": "Dr.",
        "credential": "PHD HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040653A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.