Individual provider Active NPI

Le'Roy E Reese, PH.D.

  • Clinical Psychologist
  • Decatur, GA
National Provider Identifier
1982769006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY002464 Issued in GA
Practice address
103 N McDonough St
Rear Unit
Decatur, GA 30030-3317
Phone
(404) 378-7309
Fax
(404) 378-7310
NPI assigned
Dec 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY002464 GA Primary

Addresses

Primary practice location

103 N McDonough St
Rear Unit
Decatur, GA 30030-3317

Mailing address

PO Box 832152
Stone Mountain, GA 30083-0036
Phone (404) 378-7309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150708002901 GA Practitioner - Psychologist Billing Independently 3375855158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

125 E Trinity Place
Suite 310
Decatur, GA 30030-3360
Phone (404) 378-7309

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PSY002464GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Akoma Counseling & Consulting, Inc CurrentSince Dec 18, 2014 Accepting new patients
Akoma Consulting Inc Past Accepting new patients
Ler & Associates, LLC Clinical Past Accepting new patients

Locations

125 E Trinity Pl
Ste 310
Decatur, GA 30030
Phone (404) 378-7309

Organizations & group practices 3

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": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982769006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 832152",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300830036",
            "telephone_number": "404-378-7309",
            "fax_number": "404-378-7310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N MCDONOUGH ST",
            "address_2": "REAR UNIT",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303317",
            "telephone_number": "404-378-7309",
            "fax_number": "404-378-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "LE'ROY",
        "middle_name": "E",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.