Leslie Kjosa Sutro, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

8871 Issued in MA

Practice address

41 Pacella Park Dr
Randolph, MA 02368-1755

Phone

(781) 437-1250

NPI assigned

Aug 8, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Leslie Anne Kjosa Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218153600000",
    "number": "1598911679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 PACELLA PARK DR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023681755",
            "telephone_number": "781-437-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 PACELLA PARK DR",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023681755",
            "telephone_number": "781-437-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTRO",
        "first_name": "LESLIE",
        "middle_name": "KJOSA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-08",
        "last_updated": "2008-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "8871",
            "primary": true
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "MA",
            "license": "8871",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "KJOSA",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexia Sullivan
• Caitlin Sullivan
• Kayleigh Sullivan
• Yangyang Sun
• Arysa Sutherland, LPC
• Swaddle Healthcare Services
• Kenson Sylvain
• Victoria Symkus
• Tasha M Taitt
• Tanya L Taylor, MS

• Clinical Child & Adolescent Psychologist in Randolph, MA
• Providers in Randolph, MA by specialty
• Clinical Child & Adolescent Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.