Individual provider Active NPI

Toni M Leo, PHD

  • Clinical Psychologist
  • Sierra Vista, AZ
National Provider Identifier
1801066089
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3296 Issued in AZ
Practice address
1865 Paseo San Luis Ste B
Sierra Vista, AZ 85635-5816
Phone
(520) 417-2055
NPI assigned
Mar 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3296 AZ Primary

Addresses

Primary practice location

1865 Paseo San Luis Ste B
Sierra Vista, AZ 85635-5816

Mailing address

1865 Paseo San Luis Ste B
Sierra Vista, AZ 85635-5816
Phone (520) 417-2055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, CO2 enrollments
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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050824000042 AZ Practitioner - Clinical Psychologist 9537072988 Reassigns benefits to 1 organization
I20241231002377 CO Practitioner - Clinical Psychologist 9537072988 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3296AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychologist CurrentSince Nov 27, 2024 Accepting new patients
Doctor on Demand Professionals of Texas, P.a. Past Accepting new patients
Virginia Pediatric and Adolescent Medicine Past Accepting new patients

Locations

4600 E Washington St
Ste 300
Phoenix, AZ 85034
Phone (602) 638-1872

5445 Dtc Pkwy
Ph 4
Greenwood Village, CO 80111
Phone (720) 571-4874

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 3

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": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1801066089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1865 PASEO SAN LUIS STE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856355816",
            "telephone_number": "520-417-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1865 PASEO SAN LUIS STE B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856355816",
            "telephone_number": "520-417-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEO",
        "first_name": "TONI",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.