Individual provider Active NPI

Lorinn M. Leibrock, M.A., PSY.D.

  • Clinical Psychologist
  • Brookfield, CT
National Provider Identifier
1346361250
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
003279 Issued in CT
Practice address
2 Old New Milford Rd
Suite 1E
Brookfield, CT 06804-2426
Phone
(203) 885-0500
NPI assigned
Apr 2, 2007
Last updated
May 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2015

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 003279 CT Primary

Addresses

Primary practice location

2 Old New Milford Rd
Suite 1E
Brookfield, CT 06804-2426

Mailing address

2 Old New Milford Rd
Suite 1E
Brookfield, CT 06804-2426
Phone (203) 885-0500

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
I20240909001501 CT Practitioner - Clinical Psychologist 3678013323 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Neuropsychology, LLC CurrentSince Sep 9, 2024 Accepting new patients
Advanced Telepsych PLLC PastSince Jan 1, 2024 Accepting new patients

Locations

609 W Johnson Ave
Ste 104
Cheshire, CT 06410
Phone (203) 272-6007

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1346361250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 OLD NEW MILFORD RD",
            "address_2": "SUITE 1E",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042426",
            "telephone_number": "203-885-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 OLD NEW MILFORD RD",
            "address_2": "SUITE 1E",
            "city": "BROOKFIELD",
            "state": "CT",
            "postal_code": "068042426",
            "telephone_number": "203-885-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBROCK",
        "first_name": "LORINN",
        "middle_name": "M.",
        "credential": "M.A., PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, CT

Sources for this page

Verify at the official NPI Registry.