Individual
DR. SUSAN ELIZABETH LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
(919) 350-2995
Mailing address
PO BOX 602368, CHARLOTTE, NC 28260-2368
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PSY2859
NC
103T00000X
Psychologist
PSY2859
NC
103TC0700X
Clinical Psychologist
Primary
PSY2859
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046G0
BCBS
NC
01
—
0508313
CIGNA
NC
05
—
1093871188
—
NC
05
—
6000628
—
NC
01
—
786099000
MAGELLAN
NC
01
—
D9059
MEDCOST
NC
Enumeration date
12/31/2006
Last updated
03/28/2022
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