Active NPI
Leandra Jonicole Stewart, PHD
- Clinical Psychologist
- Seattle, WA
National Provider Identifier
1497038731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60649774
- Practice address
- 10011 21St Ave SW
Seattle, WA 98146-3704 - Phone
- (206) 495-2888
- NPI assigned
- Sep 22, 2011
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY60649774 | WA | Primary |
Addresses
Primary practice location
10011 21St Ave SW
Seattle, WA 98146-3704
Mailing address
126 SW 148TH St
Ste C100-Box #565
Burien, WA 98166-1984
Phone (206) 495-2888
Other practice location 1
1600 E Olive St
Sound Mental Health
Seattle, WA 98122-2735
Phone (206) 302-2200
Other names 1
- Leandra Jonicole Shipley
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 1, 2026 through Jun 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60649774 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679097600000",
"number": "1497038731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 SW 148TH ST",
"address_2": "STE C100-BOX #565",
"city": "BURIEN",
"state": "WA",
"postal_code": "981661984",
"telephone_number": "206-495-2888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10011 21ST AVE SW",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981463704",
"telephone_number": "206-495-2888"
}
],
"practiceLocations": [
{
"address_1": "1600 E Olive St",
"address_2": "Sound Mental Health",
"address_purpose": "LOCATION",
"city": "Seattle",
"state": "WA",
"postal_code": "981222735",
"country_code": "US",
"telephone_number": "206-302-2200",
"fax_number": "206-302-2210",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "STEWART",
"first_name": "LEANDRA",
"middle_name": "JONICOLE",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-22",
"last_updated": "2023-03-18",
"certification_date": "2023-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60649774",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LEANDRA",
"last_name": "SHIPLEY",
"middle_name": "JONICOLE",
"credential": "PHD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.