NANCY S. LEAKE (NPI# 1902872328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902872328 |
| Entity Type | Individual |
| Full Name | NANCY S. LEAKE |
| Credential | APRN |
| Practice Address |
103 S Main St Middletown CT 06457-3651 |
| Mailing Address |
28 Crescent St Middletown CT 06457-3654 |
| Practice Telephone | 8603588760 |
| Practice Fax Number | 8603588754 |
| Mailing Telephone | 8603588760 |
| Mailing Fax Number | 8603588754 |
| Enumeration Date | 2006-02-25 |
| Last Update Date | 2012-03-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
1012 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 364SP0809X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Adult |
001012 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | APRN CONN LICENSE | 001012 | 01 |
| Street Address |
103 S MAIN ST |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-3651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396257309 | Karin Sidman-croghan | Counselor | 103 S Main St, Middletown, CT 06457-3651 | 2017-10-31 |
| 1710436993 | David Spiro Jr. | Social Worker | 103 S Main St, Middletown, CT 06457-3651 | 2016-09-28 |
| 1710204987 | Patrice Janell Holmes | Psychiatry & Neurology | 103 S Main St, Center for Behavioral Health Outpatient, Middletown, CT 06457-3651 | 2010-04-28 |
| 1679715023 | Laura Baird | Psychologist | 103 S Main St, Center of Behavioral Health, Middletown, CT 06457-3651 | 2009-04-01 |
| 1528091311 | Steven P Gersten | Psychiatry & Neurology | 103 S Main St, Middletown, CT 06457-3651 | 2006-07-08 |
| 1902862311 | Richard K. Tsukada | Social Worker | 103 S Main St, Middletown, CT 06457-3651 | 2006-04-25 |
| 1376519793 | Lawrence J. Byron | Social Worker | 103 S Main St, Middletown, CT 06457-3651 | 2006-02-25 |
| 1275509697 | Scott T Jones | Psychologist | 103 S Main St, Middletown, CT 06457-3651 | 2006-02-25 |
| 1003898172 | Richard M. Ketai | Psychiatry & Neurology | 103 S Main St, Middletown, CT 06457-3651 | 2005-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568096790 | Northpoint Psychiatric Consultants LLC | Nurse Practitioner | 363 Main St Ste 412, Middletown, CT 06457-3359 | 2020-02-26 |
| 1083146112 | Ildiko Maria Sherman | Nurse Practitioner | 307 Stanley St, Middletown, OH 45044-4859 | 2017-03-29 |
| 1437534401 | Gagne Behavioral Health Inc | Nurse Practitioner | 1717 Country Club Rd, Middletown, CT 06457-2363 | 2015-07-20 |
| 1609284827 | Debra Mayers | Nurse Practitioner | 31 Connors Rd, Middletown, NY 10941-1830 | 2014-07-31 |
| 1649410820 | Christopher Mcgirr | Nurse Practitioner | 120 Rising Trail Dr, Middletown, CT 06457-1671 | 2009-02-27 |
| 1902998263 | Sandra J. Rabis | Nurse Practitioner | 79 Mill St, Suite 101, Middletown, CT 06457-4468 | 2006-09-28 |
| 1992771315 | Wendy Levin Peterson | Nurse Practitioner | 267 William St, Middletown, CT 06457 | 2006-02-25 |
| 1720628910 | Kingsley Azeez Ayoola | Nurse Practitioner | 11 Little Cir, Middletown, DE 19709 | 2020-01-15 |
| 1124674148 | Mary Beatrice O'hara | Nurse Practitioner | 675 Main St, Middletown, CT 06457 | 2019-08-15 |
| 1265086102 | Emily Juliana Friedman | Nurse Practitioner | 1250 Silver St, Middletown, CT 06457-3946 | 2019-07-29 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
Please comment or provide details below to improve the information on NANCY S. LEAKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.