Individual provider Active NPI

Leeann Paquette, PSYD

  • Clinical Psychologist
  • Saratoga Springs, NY
National Provider Identifier
1720010218
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
017628 Issued in NY
Practice address
120 West Ave Ste 208
Saratoga Springs, NY 12866-6077
Phone
(518) 560-9645
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 017628 NY Primary
Clinical Psychologist 103TC0700X 048-0000705 VT

Addresses

Primary practice location

120 West Ave Ste 208
Saratoga Springs, NY 12866-6077

Mailing address

120 West Ave Ste 208
Saratoga Springs, NY 12866-6077
Phone (518) 560-9645

Other identifiers 2

IdentifierTypeStateIssuer
03030568MedicaidNY
1006115MedicaidVT

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
I20080820000433 NY Practitioner - Clinical Psychologist 8123192812 Practice locations: Saratoga Springs, NY

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)

462 Maple Ave
Saratoga Springs, NY 12866-5508
Phone (518) 560-9645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017628NYMDClinical Psychologist
048-0000705VTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
World Chiropractic, PC PastSince Feb 5, 1998 Accepting new patients
Marc D Price DO PLLC PastSince Jan 1, 2006 Accepting new patients

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1720010218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WEST AVE STE 208",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666077",
            "telephone_number": "518-560-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WEST AVE STE 208",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128666077",
            "telephone_number": "518-560-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUETTE",
        "first_name": "LEEANN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017628",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "048-0000705",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03030568",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006115",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga Springs, NY

Sources for this page

Verify at the official NPI Registry.