Leslie Lange, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

022683 Issued in NY

Practice address

604 Monterey Ave
Pelham, NY 10803-2514

Phone

(818) 657-9487

NPI assigned

Oct 27, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, NY, CA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Clinical Psychologist

Education

Other, 1989

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Sentinel Services Group Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Spring Valley, NY
  • NPI 1144891375
  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  CT, NY

  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741392000000",
    "number": "1497207211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 MONTEREY AVE",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108032514",
            "telephone_number": "818-657-9487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 MONTEREY AVE",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108032514",
            "telephone_number": "818-657-9487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "132 Larchmont Ave",
            "address_purpose": "LOCATION",
            "city": "Larchmont",
            "state": "NY",
            "postal_code": "105382869",
            "country_code": "US",
            "telephone_number": "818-657-9487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANGE",
        "first_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2025-03-08",
        "certification_date": "2025-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY12673",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "022683",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003655",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yoko Koike, ATC
• Gabriela Hannah Kostzer, PSYD
• Judith A Kulk, NURSE PRACTITIONER
• Gaytri Kumar, P.A.
• Rosa Veronica Kurtz
• Latchsmilelove
• Christopher Lauretani, MS,PT
• Eugene G Layne, LMHC,CRC
• Caitlin Leavey, LMHC
• Jennifer Ledesma, LCSW

• Clinical Psychologist in Pelham, NY
• Providers in Pelham, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.