Individual provider Active NPI

Leora Heckelman, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1699827238
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0168111 Issued in NY
Practice address
330 W 58TH St Ste 607
New York, NY 10019-1818
Phone
(212) 586-5268
NPI assigned
Jan 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0168111 NY Primary

Addresses

Primary practice location

330 W 58TH St Ste 607
New York, NY 10019-1818

Mailing address

330 W 58TH St Ste 607
New York, NY 10019-1818
Phone (212) 586-5268

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20140204000057 NY Practitioner - Clinical Psychologist 7315176831 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Harvard Medical School, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

330 W 58TH St
Suite 607
New York, NY 10019-1817
Phone (212) 586-5268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0168111NYMDClinical Psychologist
011681NYMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699827238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 607",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191818",
            "telephone_number": "212-586-5268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W 58TH ST STE 607",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100191818",
            "telephone_number": "212-586-5268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKELMAN",
        "first_name": "LEORA",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "0168111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.