Matthew S. Burgess Leary, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3953 Issued in NC

Practice address

1923 J N Pease PL
Suite 204
Charlotte, NC 28262-4513

Phone

(704) 503-3535

Fax

(704) 593-5555

NPI assigned

May 18, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Psychological Services of Charlotte

  • Psychologist
  • Charlotte, NC
  • NPI 1295768943
  NPD (past)

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1730397191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 J N PEASE PL",
            "address_2": "SUITE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624513",
            "telephone_number": "704-503-3535",
            "fax_number": "704-593-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1923 J N PEASE PL",
            "address_2": "SUITE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624513",
            "telephone_number": "704-503-3535",
            "fax_number": "704-593-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEARY",
        "first_name": "MATTHEW",
        "middle_name": "S. BURGESS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "3953",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "3953",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Learning Village Academy LLC
• Leary Family Dentistry
• Allyssa Jayne Leary, BCBA
• Amy E Leary, L.C.S.W., L.C.A.S.
• Martha Leah Leary, LCSWA
• Nicholas Leary, RN
• Victoria Isabella Leary, PT, DPT
• Larry P Lease, P.A.
• Stephanie Maho Benton Leasure, FNP
• Leah Leath

• Psychologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.