Individual provider Active NPI

Jil Leverone, PH.D.

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1821193111
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP2924 Issued in MN
Practice address
2301 Como Ave
203
Saint Paul, MN 55108-1718
Phone
(651) 646-3687
Fax
(651) 645-8026
NPI assigned
Sep 13, 2006
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 LP2924 MN Primary

Addresses

Primary practice location

2301 Como Ave
203
Saint Paul, MN 55108-1718

Mailing address

2301 Como Ave
203
Saint Paul, MN 55108-1718

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090225000134 MN Practitioner - Clinical Psychologist 3577628668 Practice locations: Saint Paul, MN

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

348 Prior Ave N
Suite 205
Saint Paul, MN 55104-5591
Phone (612) 281-5265

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP2924MNMDPsychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821193111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 COMO AVE",
            "address_2": "203",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 COMO AVE",
            "address_2": "203",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081718",
            "telephone_number": "651-646-3687",
            "fax_number": "651-645-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVERONE",
        "first_name": "JIL",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP2924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.