Active NPI
John J Leahy, EDD
- Clinical Psychologist
- Quincy, MA
National Provider Identifier
1386734572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5084
- Practice address
- Nova Psychiatric Services Inc
1261 Furnace Brook Parkway
Quincy, MA 02169 - Phone
- (617) 479-4545
- Fax
- (617) 479-4555
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | 5084 | MA | |
| Clinical Psychologist | 103TC0700X | 5084 | MA | Primary |
Addresses
Primary practice location
Nova Psychiatric Services Inc
1261 Furnace Brook Parkway
Quincy, MA 02169
Mailing address
Nova Psychiatric Services Inc
1261 Furnace Brook Parkway
Quincy, MA 02169
Phone (617) 479-4545
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6100041 | Other | MA | EVERCARE PROVIDER NUMBER |
| 1891227 | Medicaid | MA | |
| W04815 | Other | MA | BCBS PROVIDER NUMBER |
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 |
|---|---|---|---|
| 5084 | MA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurobehavioral Associates III, Inc | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Geriatric Psychiatry Physician
- Weymouth, MA
- NPI 1205926946
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551139200000",
"number": "1386734572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NOVA PSYCHIATRIC SERVICES INC",
"address_2": "1261 FURNACE BROOK PARKWAY",
"city": "QUINCY",
"state": "MA",
"postal_code": "02169",
"telephone_number": "617-479-4545",
"fax_number": "617-479-4555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NOVA PSYCHIATRIC SERVICES INC",
"address_2": "1261 FURNACE BROOK PARKWAY",
"city": "QUINCY",
"state": "MA",
"postal_code": "02169",
"telephone_number": "617-479-4545",
"fax_number": "617-479-4555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEAHY",
"first_name": "JOHN",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "EDD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2019-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "MA",
"license": "5084",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "5084",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE PROVIDER NUMBER",
"identifier": "6100041",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1891227",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "W04815",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.