Individual provider Active NPI

Leone Legan, PSYD

  • Clinical Psychologist
  • Peoria, IL
National Provider Identifier
1710954953
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071005199 Issued in IL
Practice address
5409 N Knoxville Ave
Psychological Associates
Peoria, IL 61614
Phone
(309) 691-0420
Fax
(309) 691-0520
NPI assigned
Mar 7, 2006
Last updated
Aug 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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 071005199 IL Primary

Addresses

Primary practice location

5409 N Knoxville Ave
Psychological Associates
Peoria, IL 61614

Mailing address

5409 N Knoxville Ave
Arc Building
Peoria, IL 61614-5069
Phone (309) 691-0420

Other identifiers 1

IdentifierTypeStateIssuer
07220997OtherBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20040803000234 IL Practitioner - Clinical Psychologist 3870564008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-0420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Associates Professionals LLC Clinical CurrentSince May 1, 2004 Accepting new patients

Locations

5409 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-1000

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1710954953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 N KNOXVILLE AVE",
            "address_2": "ARC BUILDING",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145069",
            "telephone_number": "309-691-0420",
            "fax_number": "309-691-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 N KNOXVILLE AVE",
            "address_2": "PSYCHOLOGICAL ASSOCIATES",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-691-0420",
            "fax_number": "309-691-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGAN",
        "first_name": "LEONE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071005199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "07220997",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.