Organization Active NPI

Simone Leavell Bruce, PLLC

  • Psychologist
  • Concord, NC
National Provider Identifier
1538075825
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
SIMONE LEAVELL BRUCE, PLLC
Practice address
4220 Stream Dale Cir NW
Concord, NC 28027-0272
Phone
(502) 417-0789
Fax
(502) 417-0789
NPI assigned
Aug 19, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Authorized official

Name
Dr. Simone Leavell Leavell, PSYD
Title
Clinical Psychologist
Phone
(502) 417-0789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

4220 Stream Dale Cir NW
Concord, NC 28027-0272

Mailing address

350 George W Liles Pkwy NW Ste 160
Concord, NC 28027-2411
Phone (502) 417-0789

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1538075825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 GEORGE W LILES PKWY NW STE 160",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280272411",
            "telephone_number": "502-417-0789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 STREAM DALE CIR NW",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280270272",
            "telephone_number": "502-417-0789",
            "fax_number": "502-417-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMONE LEAVELL BRUCE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "LEAVELL",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_middle_name": "LEAVELL",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "502-417-0789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; 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.