Active NPI
Shawn M. Leslie, PSYD
- Psychologist
- Saint Cloud, MN
National Provider Identifier
1801660618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 3701 12TH St N Ste 206
Saint Cloud, MN 56303-2253 - Phone
- (320) 229-4918
- NPI assigned
- Nov 13, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
3701 12TH St N Ste 206
Saint Cloud, MN 56303-2253
Mailing address
3701 12TH St N Ste 206
Saint Cloud, MN 56303-2253
Phone (320) 229-4918
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241029003901 | MN | Practitioner - Clinical Psychologist | 8123551116 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699833600000",
"number": "1801660618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3701 12TH ST N STE 206",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032253",
"telephone_number": "320-229-4918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 12TH ST N STE 206",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563032253",
"telephone_number": "320-229-4918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LESLIE",
"first_name": "SHAWN",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-11-13",
"last_updated": "2023-11-13",
"certification_date": "2023-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.