Individual provider Active NPI

Ruth Q Leibowitz, PH.D.

  • Clinical Psychologist
  • Portland, OR
National Provider Identifier
1770758088
Registry record updated Jun 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1848 Issued in OR
Practice address
3835 S Kelly Ave Ste 290
Portland, OR 97239-4312
Phone
(503) 927-5714
NPI assigned
Apr 28, 2008
Last updated
Jun 30, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2024

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 1848 OR Primary
Athletic Trainer 2255A2300X NU

Addresses

Primary practice location

3835 S Kelly Ave Ste 290
Portland, OR 97239-4312

Mailing address

3032 SW Florida CT Apt B
Portland, OR 97219-1870
Phone (503) 226-5841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 1, 2021 through Oct 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1848ORMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
Neurothryve Clinical PastSince Apr 5, 2014 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": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719705600000",
    "number": "1770758088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3032 SW FLORIDA CT APT B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972191870",
            "telephone_number": "503-226-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3835 S KELLY AVE STE 290",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394312",
            "telephone_number": "503-927-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOWITZ",
        "first_name": "RUTH",
        "middle_name": "Q",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-28",
        "last_updated": "2024-06-30",
        "certification_date": "2024-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "1848",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.