Mark D. Lessard, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2104-057 Issued in WI

Practice address

Ebh02
4TH Armored Drive
Fort Drum, NY 13602

Phone

(315) 772-6703

NPI assigned

Mar 24, 2006

Last updated

Oct 20, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1679533673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EBH02",
            "address_2": "4TH ARMORED DRIVE",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "13602",
            "telephone_number": "315-772-6703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EBH02",
            "address_2": "4TH ARMORED DRIVE",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "13602",
            "telephone_number": "315-772-6703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESSARD",
        "first_name": "MARK",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "2104-057",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "3-1940",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "725",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jesse K Laverdiere, DO
• Roxanne Lawler, DENTAL HYGIENIST
• Alicia Lee, RDN
• Brandon Lukas Lee, MS, RD, CSSD, CCRP
• Brooke Rita Leonelli, PH.D.
• Mark E. Lester, P.T.
• Jonathan Mark Letko, DO
• William Lewis, DO
• Kyle Libby, DMD
• Shana Hensley Lilley, DPT

• Clinical Psychologist in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.