NPIMap

Individual provider Active NPI

Steven Wilder Leclair, PH.D.

  • Clinical Psychologist
  • Gray, ME
National Provider Identifier
1821215328
Registry record updated Jun 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS 743 Issued in ME
Practice address
25 Pleasant View Dr
Gray, ME 04039-9572
Phone
(207) 428-3055
Fax
(207) 428-3069
NPI assigned
Apr 19, 2007
Last updated
Jun 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2012

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS 743 ME
Adult Development & Aging Psychologist 103TA0700X PS 743 ME
Clinical Psychologist 103TC0700X PS 743 ME Primary
Intellectual & Developmental Disabilities Psychologist 103TM1800X PS 743 ME
Group Psychotherapy Psychologist 103TP2701X PS 743 ME
Rehabilitation Psychologist 103TR0400X PS 743 ME

Addresses

Primary practice location

25 Pleasant View Dr
Gray, ME 04039-9572

Mailing address

PO Box 1140
25 Pleasant View Drive
Gray, ME 04039-1140
Phone (207) 428-3055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS 743MEMDIntellectual & Developmental Disabilities Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Leclair Behavioral Health, LLC Psychologist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1821215328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1140",
            "address_2": "25 PLEASANT VIEW DRIVE",
            "city": "GRAY",
            "state": "ME",
            "postal_code": "040391140",
            "telephone_number": "207-428-3055",
            "fax_number": "207-428-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PLEASANT VIEW DR",
            "city": "GRAY",
            "state": "ME",
            "postal_code": "040399572",
            "telephone_number": "207-428-3055",
            "fax_number": "207-428-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LECLAIR",
        "first_name": "STEVEN",
        "middle_name": "WILDER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS 743",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "ME",
            "license": "PS 743",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS 743",
            "primary": true
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "ME",
            "license": "PS 743",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "ME",
            "license": "PS 743",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "ME",
            "license": "PS 743",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gray, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.