Active NPI
Leslie A. Gavin-Devitt, PHD
- Clinical Child & Adolescent Psychologist
- Orlando, FL
National Provider Identifier
1992814750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- PY5787
- Practice address
- 1717 S Orange Ave
Suite 100
Orlando, FL 32806-2944 - Phone
- (407) 650-7000
- Fax
- (407) 650-7124
- NPI assigned
- Aug 29, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | PY5787 | FL | Primary |
Addresses
Primary practice location
1717 S Orange Ave
Suite 100
Orlando, FL 32806-2944
Mailing address
Nemours Children&Apos S Clinic
P.O. Box 409992
Atlanta, GA 30384-0001
Phone (904) 390-3610
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 768880600 | Medicaid | FL |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY5787 | FL | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210896000000",
"number": "1992814750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NEMOURS CHILDREN&APOS S CLINIC",
"address_2": "P.O. BOX 409992",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303840001",
"telephone_number": "904-390-3610",
"fax_number": "904-288-5890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 S ORANGE AVE",
"address_2": "SUITE 100",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328062944",
"telephone_number": "407-650-7000",
"fax_number": "407-650-7124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAVIN-DEVITT",
"first_name": "LESLIE",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-29",
"last_updated": "2008-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "FL",
"license": "PY5787",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "768880600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.