Individual provider Active NPI

Kaylee Leduc, PSY.D.

  • Clinical Psychologist
  • Wellesley Hills, MA
National Provider Identifier
1548701360
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY10000603 Issued in MA
Practice address
396 Washington St Ste 266
Wellesley Hills, MA 02481-6209
Phone
(855) 438-8331
NPI assigned
Mar 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Clinical Child & Adolescent Psychologist 103TC2200X PSY10000603 MA
Clinical Child & Adolescent Psychologist 103TC2200X PY12572 FL
Clinical Psychologist 103TC0700X PSY10000603 MA Primary

Addresses

Primary practice location

396 Washington St Ste 266
Wellesley Hills, MA 02481-6209

Mailing address

10491 Gandy Blvd N Unit 2-2111
St Petersburg, FL 33702-2302

Other practice location 1

9400 4th St N Ste 200
St Petersburg, FL 33702-2501
Phone (727) 513-2962

Other practice location 2

35 Summer St Ste 202
Taunton, MA 02780-3469
Phone (508) 745-3720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250522003623 FL Practitioner - Clinical Psychologist 0143749028 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PSY10000603MAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Emerald Clover, LLC CurrentSince Jun 23, 2025 Accepting new patients

Locations

9400 4th St N
Ste 200
St Petersburg, FL 33702
Phone (727) 513-2962

Organizations & group practices 1

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": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1548701360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10491 GANDY BLVD N UNIT 2-2111",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 WASHINGTON ST STE 266",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024816209",
            "telephone_number": "855-438-8331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9400 4th St N Ste 200",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337022501",
            "country_code": "US",
            "telephone_number": "727-513-2962",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Summer St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Taunton",
            "state": "MA",
            "postal_code": "027803469",
            "country_code": "US",
            "telephone_number": "508-745-3720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEDUC",
        "first_name": "KAYLEE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "PSY10000603",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY12572",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PSY10000603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley Hills, MA

Sources for this page

Verify at the official NPI Registry.