Frederick G. Leidal, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2301 Issued in CO

Practice address

9101 E Kenyon Ave Ste 2900
Denver, CO 80237-1855

Phone

(720) 489-7756

Fax

(866) 836-3632

NPI assigned

Aug 26, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1366675241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5935 N LARIAT DR",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801089367",
            "telephone_number": "720-988-3885",
            "fax_number": "866-836-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9101 E KENYON AVE STE 2900",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802371855",
            "telephone_number": "720-489-7756",
            "fax_number": "866-836-3632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3094 W Market St",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Fairlawn",
            "state": "OH",
            "postal_code": "443333626",
            "country_code": "US",
            "telephone_number": "330-873-9516",
            "fax_number": "330-864-8678",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIDAL",
        "first_name": "FREDERICK",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-26",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "OH",
            "license": "4168",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "CO",
            "license": "2301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Iris Leibowitz, MD, MPH
• Anne Watson Leibowitz, LCSW
• Samara Alexus Leicester, FAMILY NP
• Pamela Ann Leichner, R.N.
• Jamee Leichtle, LPC
• Katelyn Leidy
• Marjory Sharon Leight, MSNP
• Andrew Leighton, OTR/L
• Lucia Leighton
• Cheryl Ann Leiker, R.N.

• Clinical Neuropsychologist in Denver, CO
• Providers in Denver, CO by specialty
• Clinical Neuropsychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.