Gina M Leslie, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2003030084 Issued in MO

Practice address

2901 Bertland Ave Apt 1237
Durham, NC 27705-6825

Phone

(573) 397-2846

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Sanders Psychological Services, Inc.

  • Clinical Psychologist
  • Reeds Spring, MO
  • NPI 1821286428
  NPD

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1639256233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 BERTLAND AVE APT 1237",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277056825",
            "telephone_number": "573-397-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 BERTLAND AVE APT 1237",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277056825",
            "telephone_number": "573-397-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESLIE",
        "first_name": "GINA",
        "middle_name": "M",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810008022",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "38068",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2003030084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "499012607",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John J Leschisin
• Erin B Lesesky, M.D.
• Ebony Williams Lesesne, NP
• Leslie R. Roach, P.L.L.C.
• Leslie Stern
• Jonah Woodsong Leslie, LCMHCA, MS
• James W Lester Jr., M.D.
• Tatiana Florencia Lestido, DO
• Jason Hongting Leung, MD
• Kenneth Leung, MD

• Clinical Psychologist in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.