Organization Active NPI

Leanne Carlson, PHD, HSPP, Inc.

  • Clinical Psychologist
  • Indianapolis, IN
National Provider Identifier
1356731228
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
20040653A Issued in IN
Legal business name
LEANNE CARLSON, PHD, HSPP, INC.
Practice address
8395 Keystone Xing
Ste 104
Indianapolis, IN 46240-4307
Phone
(317) 431-0897
Fax
(317) 598-0355
NPI assigned
Jan 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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

Authorized official

Name
Dr. Leanne Carlson, PH.DNPI 1295735744
Title
Clinical Psychologist
Phone
(317) 431-0897

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 20040653A IN Primary

Addresses

Primary practice location

8395 Keystone Xing
Ste 104
Indianapolis, IN 46240-4307

Mailing address

8395 Keystone Xing
Ste 104
Indianapolis, IN 46240-4307
Phone (317) 431-0897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150317000191 IN Part B Supplier - Clinic/Group Practice 4284951047 Receives reassigned benefits from 1 practitioner
Practice locations: Indianapolis, IN

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424304000000",
    "number": "1356731228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8395 KEYSTONE XING",
            "address_2": "STE 104",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462404307",
            "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": "8395 KEYSTONE XING",
            "address_2": "STE 104",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462404307",
            "telephone_number": "317-431-0897",
            "fax_number": "317-598-0355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEANNE CARLSON, PHD, HSPP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-02-19",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "LEANNE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "317-431-0897",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040653A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2015; 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.