Individual provider Active NPI

Katherine Rayne Leahy, PSYD

  • Clinical Psychologist
  • Andover, KS
National Provider Identifier
1619168002
Registry record updated Nov 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1757 Issued in KS
Practice address
217 W Ira CT
Andover, KS 67002-9469
Phone
(316) 733-5047
NPI assigned
Aug 9, 2007
Last updated
Nov 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2014

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 1757 KS Primary

Addresses

Primary practice location

217 W Ira CT
Andover, KS 67002-9469

Mailing address

1105 N Oak Ridge Ave
Goddard, KS 67052-8621
Phone (316) 304-6104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20080112000095 KS Practitioner - Clinical Psychologist 2668553975 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9432 W Central Ave
Wichita, KS 67212-3814
Phone (316) 755-8584

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Katherine Leahy Psychology LLC CurrentSince Aug 1, 2017 Accepting new patients
South Central Mental Health Counseling Center, Inc. Clinical CurrentSince Mar 23, 2009 Accepting new patients
South Central Mental Health Counseling Center, Inc. PastSince Dec 3, 2023 Accepting new patients

Locations

217 W Ira Ct
Andover, KS 67002
Phone (316) 733-5047

2821 Brookside Ct
Augusta, KS 67010
Phone (316) 425-0073

430 N Walnut St
Augusta, KS 67010
Phone (316) 775-5491

9432 W Central Ave
Wichita, KS 67212
Phone (316) 755-8584

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1619168002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 N OAK RIDGE AVE",
            "city": "GODDARD",
            "state": "KS",
            "postal_code": "670528621",
            "telephone_number": "316-304-6104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 W IRA CT",
            "city": "ANDOVER",
            "state": "KS",
            "postal_code": "670029469",
            "telephone_number": "316-733-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAHY",
        "first_name": "KATHERINE",
        "middle_name": "RAYNE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "KS",
            "license": "1757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, KS

Sources for this page

Verify at the official NPI Registry.