Individual provider Active NPI

Priscilla F Leavitt, PHD

  • Counseling Psychologist
  • Parkersburg, WV
National Provider Identifier
1790741577
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
414 Issued in WV
Practice address
936 Market St
Parkersburg, WV 26101
Phone
(304) 422-7300
Fax
(304) 428-3719
NPI assigned
Apr 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 414 WV Primary

Addresses

Primary practice location

936 Market St
Parkersburg, WV 26101

Mailing address

936 Market St
Parkersburg, WV 26101
Phone (304) 422-7300

Other identifiers 1

IdentifierTypeStateIssuer
0162899000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20050310001050 WV Practitioner - Clinical Psychologist 7416921283 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling and Wellness Center LLCGroup PAC ID 5395983126, 17 clinicians

Practice addresses (Care Compare)

936 Market St
Parkersburg, WV 26101-4795
Phone (304) 422-7300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
414WVMDCounseling Psychologist
414OHMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling and Wellness Center LLC Counseling CurrentSince Jan 15, 2013 Accepting new patients

Locations

936 Market St
Parkersburg, WV 26101
Phone (304) 422-7300

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1790741577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "936 MARKET ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "26101",
            "telephone_number": "304-422-7300",
            "fax_number": "304-428-3719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "936 MARKET ST",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "26101",
            "telephone_number": "304-422-7300",
            "fax_number": "304-428-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAVITT",
        "first_name": "PRISCILLA",
        "middle_name": "F",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-21",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WV",
            "license": "414",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0162899000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parkersburg, WV

Sources for this page

Verify at the official NPI Registry.