Samantha Denise Lebo

Primary specialty

Adult Development & Aging PsychologistTaxonomy code 103TA0700X

Practice address

3640 Colonel Glenn Hwy
Dayton, OH 45435-0002

Phone

(937) 775-1000

NPI assigned

Nov 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Fanny NG Psychology Services PLLC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023897808
  NPD

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

{
    "created_epoch": "1572912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1407490295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 NE 3RD AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333042691",
            "telephone_number": "561-221-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 COLONEL GLENN HWY",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350002",
            "telephone_number": "937-775-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Court St Ste And1001",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112420103",
            "country_code": "US",
            "telephone_number": "646-960-3451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBO",
        "first_name": "SAMANTHA",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-05",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsea Leavitt, CDCA
• Andrew Damian Lebamoff, DO
• Damian Ivan Lebamoff, MD
• Annick Lebenns
• Amy Leber, APRN
• Wendy Leborgne, PH.D. CCC-SLP
• William K Lecain, RPH
• Amanda J Leckey, LPN, M-IV
• Kala Lecomte
• Patricia Ledford, M.ED., LSW

• All providers in Dayton, OH
• Adult Development & Aging Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; 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.