Individual provider Active NPI

Jennifer Leech, MA, CCC-SLP

  • Speech-Language Pathologist
  • Grand Rapids, MI
National Provider Identifier
1922529155
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101002650 Issued in MI
Practice address
3260 Eagle Park Dr NE Ste 117
Grand Rapids, MI 49525-4569
Phone
(616) 530-2224
Fax
(616) 825-6164
NPI assigned
Jun 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101002650 MI Primary

Addresses

Primary practice location

3260 Eagle Park Dr NE Ste 117
Grand Rapids, MI 49525-4569

Mailing address

840 Mulford Drive Southeast
Grand Rapids, MI 49507
Phone (616) 514-5668

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
7101002650MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Encourage Institute for Teaching and Learning, LLC PastSince Nov 1, 2020 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498608000000",
    "number": "1922529155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 MULFORD DRIVE SOUTHEAST",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49507",
            "telephone_number": "616-514-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 EAGLE PARK DR NE STE 117",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254569",
            "telephone_number": "616-530-2224",
            "fax_number": "616-825-6164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEECH",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101002650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; 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.