Individual provider Active NPI

Leisa Dwamena, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Lowell, MA
National Provider Identifier
1740169424
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2296460 Issued in MA
Practice address
275 Varnum Ave Ste 208
Lowell, MA 01854-2109
Phone
(978) 330-6335
Fax
(978) 355-1002
NPI assigned
Aug 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2296460 MA Primary
Registered Nurse 163W00000X RN2296460 MA

Addresses

Primary practice location

275 Varnum Ave Ste 208
Lowell, MA 01854-2109

Mailing address

31 Onset St
Worcester, MA 01604-2013
Phone (603) 674-6969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260519001447 MA Practitioner - Nurse Practitioner 2163991274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

275 Varnum Ave
Suite 208
Lowell, MA 01854-2109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2296460MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Neurobridge Wellness Inc. Psychiatric/Mental Health CurrentSince May 1, 2026 Accepting new patients

Locations

275 Varnum Ave
Ste 208
Lowell, MA 01854
Phone (978) 330-6335

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1740169424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 ONSET ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016042013",
            "telephone_number": "603-674-6969",
            "fax_number": "603-674-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 VARNUM AVE STE 208",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542109",
            "telephone_number": "978-330-6335",
            "fax_number": "978-355-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWAMENA",
        "first_name": "LEISA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-28",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2296460",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2296460",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.