Donald R Lee-Edwards, PH.D,MD,LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4053692 Issued in NY

Practice address

255 Gordon St
Staten Island, NY 10304-1943

Phone

(718) 554-0744

Fax

(206) 337-9412

NPI assigned

May 14, 2012

Last updated

May 14, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

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.

• Dr. Donald R Lee-Edwards PH.D, LP

  • Adult Mental Health Clinic/Center
  • Staten Island, NY
  • NPI 1710252127
  NPD (past) Authorized official

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336953600000",
    "number": "1871852699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 GORDON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041943",
            "telephone_number": "718-554-0744",
            "fax_number": "206-337-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 GORDON ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041943",
            "telephone_number": "718-554-0744",
            "fax_number": "206-337-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE-EDWARDS",
        "first_name": "DONALD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D,MD,LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-14",
        "last_updated": "2012-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "4053692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1710252127",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elissa Lebow, PA-C
• Edward Leccese, LMT
• Lynda Lederer Elbaz, M.S.
• Josiane Lederman, M.D.
• Lee M Turner LCSW, PC
• Mary Rose Quan Lee-Llacer, M.D.
• Adrienne D Lee, M.S.CCC/SLP
• Alex Lee
• Andy Sangyoon Lee
• Anita Cher-Jen Lee, PA-C

• Clinical Psychologist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.