Active NPI
Leslie Matlen, PH.D.
- Clinical Psychologist
- Longmeadow, MA
National Provider Identifier
1366514671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6162
- Practice address
- 568 Pinewood Dr
Longmeadow, MA 01106-1665 - Phone
- (413) 565-5101
- Fax
- (413) 567-6998
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6162 | MA | Primary |
| Clinical Psychologist | 103TC0700X | 001669 | CT |
Addresses
Primary practice location
568 Pinewood Dr
Longmeadow, MA 01106-1665
Mailing address
568 Pinewood Dr
Longmeadow, MA 01106-1665
Phone (413) 565-5101
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0526053 | Medicaid | MA |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6162 | MA | MD | Mental Health Counselor |
| 001669 | CT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366514671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "568 PINEWOOD DR",
"city": "LONGMEADOW",
"state": "MA",
"postal_code": "011061665",
"telephone_number": "413-565-5101",
"fax_number": "413-567-6998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "568 PINEWOOD DR",
"city": "LONGMEADOW",
"state": "MA",
"postal_code": "011061665",
"telephone_number": "413-565-5101",
"fax_number": "413-567-6998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATLEN",
"first_name": "LESLIE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "6162",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CT",
"license": "001669",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0526053",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Longmeadow, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.