Individual provider Active NPI

Donna L Leitner, PH.D.

  • Psychologist
  • Stroudsburg, PA
National Provider Identifier
1811037765
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LE1448078 Issued in PA
Practice address
134 Broad St
Stroudsburg, PA 18360-1590
Phone
(570) 236-4966
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LE1448078 PA Primary

Addresses

Primary practice location

134 Broad St
Stroudsburg, PA 18360-1590

Mailing address

134 Broad St
Stroudsburg, PA 18360-1590
Phone (570) 236-4966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170524001458 PA Practitioner - Clinical Psychologist 5597044180 Practice locations: Stroudsburg, PA
I20240222000525 SC Practitioner - Clinical Psychologist 5597044180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oceanic Counseling Group LLCGroup PAC ID 4486067600, 42 clinicians

Practice addresses (Care Compare)

11947 Grandhaven Dr
Suite N
Murrells Inlet, SC 29576-7862
Phone (843) 894-0000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LE1448078PAMDPsychologist
1802SCMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Oceanic Counseling Group LLC CurrentSince Feb 8, 2024 Accepting new patients
Oceanic Psychiatric Medicine PastSince Apr 6, 2023 Accepting new patients

Locations

11947 Grandhaven Dr
Ste N
Murrells Inlt, SC 29576
Phone (843) 652-4600

Organizations & group practices 2

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": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811037765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 BROAD ST",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183601590",
            "telephone_number": "570-236-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 BROAD ST",
            "city": "STROUDSBURG",
            "state": "PA",
            "postal_code": "183601590",
            "telephone_number": "570-236-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITNER",
        "first_name": "DONNA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "LE1448078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stroudsburg, PA

Sources for this page

Verify at the official NPI Registry.