Michelle Jaques-Leonard, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

11862 Issued in MA

Practice address

24 Newton St
Southborough, MA 01772-1215

Phone

(508) 856-0732

NPI assigned

Mar 25, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: michelle.jaquesleonard.npi1598296063.reliant@direct.optumcare.masshiway.net

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.

• Reliant Medical Group, Inc

  • Family Medicine Physician
  • Worcester, MA
  • NPI 1720017528
  Medicare reassignment NPD

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

{
    "created_epoch": "1490400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1598296063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E MAIN RD",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "028712308",
            "telephone_number": "508-439-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 NEWTON ST",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721215",
            "telephone_number": "508-856-0732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAQUES-LEONARD",
        "first_name": "MICHELLE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-25",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patriciaanne Rockefeller Hurley
• Nishanthi Ihalawithanage
• Roshwaun Isidor
• Juliet Jacobs
• Robert C. Jandl, M.D.
• Gina Jennings
• Kellsie Anna Jensen
• Preeti Jha
• Averi Johnson, LADC II
• Precious Johnson

• Clinical Psychologist in Southborough, MA
• Providers in Southborough, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.