Active NPI
Madeleine Leake, PSYD
- Clinical Psychologist
- Valley Village, CA
National Provider Identifier
1336640226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 29896
- Practice address
- 12501 Chandler Blvd Ste 102
Valley Village, CA 91607-1955 - Phone
- (818) 724-9822
- NPI assigned
- Feb 26, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 29896 | CA | Primary |
Addresses
Primary practice location
12501 Chandler Blvd Ste 102
Valley Village, CA 91607-1955
Mailing address
12501 Chandler Blvd Ste 102
Valley Village, CA 91607-1955
Phone (504) 715-8122
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29896 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519603200000",
"number": "1336640226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12501 CHANDLER BLVD STE 102",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916071955",
"telephone_number": "504-715-8122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12501 CHANDLER BLVD STE 102",
"city": "VALLEY VILLAGE",
"state": "CA",
"postal_code": "916071955",
"telephone_number": "818-724-9822"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAKE",
"first_name": "MADELEINE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-02-26",
"last_updated": "2018-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "29896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Village, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.