Leah Faber, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

12351 Issued in FL

Practice address

12791 World Plaza LN BLDG 89
Fort Myers, FL 33907-3989

Phone

(630) 956-6332

Fax

(239) 645-4777

NPI assigned

Aug 30, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Clinical Psychologist

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fort Myers Psychology PAGroup PAC ID 6204936305, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fort Myers Psychology, PA

  • Clinical Psychologist
  • Fort Myers, FL
  • NPI 1003028119
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1700610847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12791 WORLD PLAZA LN BLDG 89",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073989",
            "telephone_number": "630-956-6332",
            "fax_number": "239-645-4777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12791 WORLD PLAZA LN BLDG 89",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073989",
            "telephone_number": "630-956-6332",
            "fax_number": "239-645-4777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABER",
        "first_name": "LEAH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "12351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eypr Ome Health Care Inc
• Ez RX Bonita Springs LLC
• Ez RX Bonita Springs LLC
• Ikechukwu V Ezenwa, PHARM.D., PH.D.
• Douglas Faas, OT 17824
• Carolina Fabian, LMFT
• Camila Shaiel Fabius
• Sarah Elizabeth Fabrizi, OTR/L
• Jordan Antonio Facey, PA-C
• Melissa Facey

• Clinical Psychologist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.