Active NPI
Jacqueline Wendy Leibsohn, PH.D.
- Psychologist
- Seattle, WA
National Provider Identifier
1528236833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 1478
- Practice address
- 1820 12TH Ave
Seattle, WA 98122-2438 - Phone
- (206) 296-5766
- NPI assigned
- Feb 20, 2008
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 1478 | WA | Primary |
Addresses
Primary practice location
1820 12TH Ave
Seattle, WA 98122-2438
Mailing address
PO Box 222000
Seattle University, Loyola 212
Seattle, WA 98122
Phone (206) 296-5766
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Sep 7, 2023 through Sep 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1478 | WA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203465600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203465600000",
"number": "1528236833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 222000",
"address_2": "SEATTLE UNIVERSITY, LOYOLA 212",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98122",
"telephone_number": "206-296-5766",
"fax_number": "206-296-1892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1820 12TH AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981222438",
"telephone_number": "206-296-5766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIBSOHN",
"first_name": "JACQUELINE",
"middle_name": "WENDY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-02-20",
"last_updated": "2008-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "1478",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Feb 20, 2008; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.