Individual provider Active NPI

Leann Terry Diederich, PHD

  • Counseling Psychologist
  • Lemont, PA
National Provider Identifier
1962529503
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PS017258 Issued in PA
Practice address
720 Pike Street
Suite 3
Lemont, PA 16851
Phone
(814) 777-8899
NPI assigned
Mar 26, 2007
Last updated
Apr 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PS017258 PA Primary

Addresses

Primary practice location

720 Pike Street
Suite 3
Lemont, PA 16851

Mailing address

PO Box 655
Lemont, PA 16851-0655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20251014000035 PA Practitioner - Clinical Psychologist 5698262780 Practice locations: Lemont, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

720 Pike St
Suite 3
Lemont, PA 16851-9085
Phone (814) 321-7440

PO Box
Suite 655
Lemont, PA 16851-0655

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sweet Springs Consultation and Assessment PLLC CurrentSince Jul 16, 2023 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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1962529503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 655",
            "city": "LEMONT",
            "state": "PA",
            "postal_code": "168510655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 PIKE STREET",
            "address_2": "SUITE 3",
            "city": "LEMONT",
            "state": "PA",
            "postal_code": "16851",
            "telephone_number": "814-777-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEDERICH",
        "first_name": "LEANN",
        "middle_name": "TERRY",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS017258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemont, PA

Sources for this page

Verify at the official NPI Registry.