Individual provider Active NPI

Jennifer Leach, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1639396211
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
016548-68 Issued in NY
Practice address
7 W 30TH St
Floor 11 Room 11
New York, NY 10001-4406
Phone
(917) 475-9614
NPI assigned
Apr 18, 2007
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 016548-68 NY Primary

Addresses

Primary practice location

7 W 30TH St
Floor 11 Room 11
New York, NY 10001-4406

Mailing address

7 W 30TH St
Floor 11 Room 11
New York, NY 10001-4406
Phone (917) 475-9614

Other identifiers 1

IdentifierTypeStateIssuer
016548OtherNYCLINCAL PSYCHOLOGY LICENSE

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
016548-68NYMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Postgraduate Center for Mental Health PastSince Apr 6, 2009 Accepting new patients

Organizations & group practices 1

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1639396211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 W 30TH ST",
            "address_2": "FLOOR 11 ROOM 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014406",
            "telephone_number": "917-475-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 W 30TH ST",
            "address_2": "FLOOR 11 ROOM 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100014406",
            "telephone_number": "917-475-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEACH",
        "first_name": "JENNIFER",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016548-68",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINCAL PSYCHOLOGY LICENSE",
            "identifier": "016548",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.