Individual provider Active NPI

Leslie Ellen Ackerman, PSY.D.

  • Psychologist
  • Eastchester, NY
National Provider Identifier
1619117991
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
475 White Plains Rd Ste 23
Eastchester, NY 10709-5537
Phone
(952) 210-8636
NPI assigned
Feb 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X Primary

Addresses

Primary practice location

475 White Plains Rd Ste 23
Eastchester, NY 10709-5537

Mailing address

475 White Plains Rd Ste 23
Eastchester, NY 10709-5537
Phone (952) 210-8636

Other identifiers 1

IdentifierTypeStateIssuer
03109560MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
018053NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostics, LLP Psychologist PastSince Mar 1, 2009 Accepting new patients
Knapp Street Psychiatry, PC PastSince Feb 2, 2020 Accepting new patients
Che Senior Psychological Services, PC PastSince Feb 2, 2020 Accepting new patients

Organizations & group practices 3

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": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1619117991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 WHITE PLAINS RD STE 23",
            "city": "EASTCHESTER",
            "state": "NY",
            "postal_code": "107095537",
            "telephone_number": "952-210-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 WHITE PLAINS RD STE 23",
            "city": "EASTCHESTER",
            "state": "NY",
            "postal_code": "107095537",
            "telephone_number": "952-210-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "LESLIE",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-26",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03109560",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastchester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2013; 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.