Justine Melisande Leonard, MFC36954

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

36954 Issued in CA

Practice address

37 Ledges LN
Freedom, ME 04941-3247

Phone

(510) 710-2301

NPI assigned

Mar 25, 2025

Last updated

Mar 25, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Justine Melisande Polevoy Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1982406740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 LEDGES LN",
            "city": "FREEDOM",
            "state": "ME",
            "postal_code": "049413247",
            "telephone_number": "510-710-2301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 LEDGES LN",
            "city": "FREEDOM",
            "state": "ME",
            "postal_code": "049413247",
            "telephone_number": "510-710-2301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2824 College Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947052114",
            "country_code": "US",
            "telephone_number": "510-710-2301",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "37 Ledges Ln",
            "address_purpose": "LOCATION",
            "city": "Freedom",
            "state": "ME",
            "postal_code": "049413247",
            "country_code": "US",
            "telephone_number": "510-710-2301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEONARD",
        "first_name": "JUSTINE",
        "middle_name": "MELISANDE",
        "credential": "MFC36954",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "36954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUSTINE",
            "last_name": "POLEVOY",
            "middle_name": "MELISANDE",
            "credential": "MFC36954",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jenna Payne, CPM, LM
• Cassandra Kennedy Redwine
• Kristen N. Sheppard, LCSW
• Dawnella Sutton

• Marriage & Family Therapist in Freedom, ME
• Providers in Freedom, ME by specialty
• Marriage & Family Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.