Individual provider Active NPI

Leonard Joel Guedalia, PH.D.

  • Psychologist
  • Bethesda, MD
National Provider Identifier
1720368590
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
01512 Issued in MD
Practice address
4400 E West Hwy
Suite 712
Bethesda, MD 20814-4524
Phone
(301) 907-8995
NPI assigned
Aug 24, 2011
Last updated
Sep 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 01512 MD Primary

Addresses

Primary practice location

4400 E West Hwy
Suite 712
Bethesda, MD 20814-4524

Mailing address

4400 E West Hwy
Suite 712
Bethesda, MD 20814-4524
Phone (301) 907-8995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2016 through Oct 1, 2026

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01512MDMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Melwood Center for Counseling & Psychotherapy,Inc. Psychologist Past Accepting new patients

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": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1720368590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 E WEST HWY",
            "address_2": "SUITE 712",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144524",
            "telephone_number": "301-907-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 E WEST HWY",
            "address_2": "SUITE 712",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144524",
            "telephone_number": "301-907-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEDALIA",
        "first_name": "LEONARD",
        "middle_name": "JOEL",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MD",
            "license": "01512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.