Individual provider Active NPI

Cynthia Rose Leon

  • Clinical Psychologist
  • Charlottesville, VA
National Provider Identifier
1538478342
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
T677297005 Issued in VA
Practice address
3040 Avemore Square PL
Charlottesville, VA 22911-7228
Phone
(434) 220-0089
Fax
(434) 220-0103
NPI assigned
Sep 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X T677297005 VA Primary

Addresses

Primary practice location

3040 Avemore Square PL
Charlottesville, VA 22911-7228

Mailing address

3040 Avemore Square PL
Charlottesville, VA 22911-7228
Phone (434) 220-0089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
T677297005VAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Youth Services CurrentSince Apr 6, 2023 Accepting new patients
Compass Youth Services PastSince Apr 6, 2023 Accepting new patients

Locations

3040 Avemore Square Pl
Charlottesville, VA 22911
Phone (434) 220-0089

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1538478342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 AVEMORE SQUARE PL",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229117228",
            "telephone_number": "434-220-0089",
            "fax_number": "434-220-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 AVEMORE SQUARE PL",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229117228",
            "telephone_number": "434-220-0089",
            "fax_number": "434-220-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEON",
        "first_name": "CYNTHIA",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "T677297005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.