Individual provider Active NPI

David Jonathan Ley Jr., PH.D.

  • Clinical Psychologist
  • Albuquerque, NM
National Provider Identifier
1699880484
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
834 Issued in NM
Practice address
707 Broadway Blvd NE
Ste 500
Albuquerque, NM 87102-2360
Phone
(505) 268-0701
NPI assigned
Aug 20, 2006
Sex
Male
Sole proprietor
No

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 834 NM Primary

Addresses

Primary practice location

707 Broadway Blvd NE
Ste 500
Albuquerque, NM 87102-2360

Mailing address

707 Broadway Blvd NE
Ste 500
Albuquerque, NM 87102-2360
Phone (505) 268-0701

Other identifiers 1

IdentifierTypeStateIssuer
56573791MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20090407000392 NM Practitioner - Clinical Psychologist 0446307565 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
834NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Healthcare Services, Inc. CurrentSince Dec 13, 2016 Accepting new patients
Behavioral Healthcare Services, Inc. Current Accepting new patients

Locations

707 Broadway Blvd NE
Ste 500
Albuquerque, NM 87102
Phone (505) 248-2726

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699880484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 BROADWAY BLVD NE",
            "address_2": "STE 500",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022360",
            "telephone_number": "505-268-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 BROADWAY BLVD NE",
            "address_2": "STE 500",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022360",
            "telephone_number": "505-268-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEY",
        "first_name": "DAVID",
        "middle_name": "JONATHAN",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "56573791",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.