LESLIE JAY SUGA


Address: 6515 E 82nd St, Suite 210, Indianapolis, IN 46250-1576
Phone: 3175590990

LESLIE JAY SUGA (NPI# 1972595684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1972595684
Entity Type Individual
Full Name LESLIE JAY SUGA
Credential PHD HSPP
Practice Address 6515 E 82nd St
Suite 210
Indianapolis
IN 46250-1576
Mailing Address 8539 Tidewater Dr
Indianapolis
IN 46236-8917
Practice Telephone 3175590990
Practice Fax Number 3176536405
Enumeration Date 2005-08-18
Last Update Date 2014-10-25
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103G00000X Clinical Neuropsychologist 20040349A IN Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN 100376990A 05
IN MEDICARE RAILROAD 680013641 01

Office Location

Street Address 6515 E 82ND ST
SUITE 210
City INDIANAPOLIS
State IN
Zip Code 46250-1576

Providers in the same location

NPI Name Taxonomy Address Enumeration
1134671035 Ernsperger Consulting LLC Community/Behavioral Health 6515 E 82nd St, Suite 110, Indianapolis, IN 46250-1576 2016-10-27
1700146008 Autism Counseling & Behavior Consultation, Inc Social Worker 6515 E 82nd St, Suite 110, Indianapolis, IN 46250-1576 2012-05-21
1528120581 Kelly Anne Ernsperger Social Worker 6515 E 82nd St, Suite 110, Indianapolis, IN 46250-1576 2006-12-15
1255421400 Outpatient Solutions LLC Durable Medical Equipment & Medical Supplies 6515 E 82nd St, Suite 103, Indianapolis, IN 46250-1576 2006-10-16
1700870128 American Nursing Care, Inc. Home Health 6515 E 82nd St, Suite 112, Indianapolis, IN 46250-1576 2005-08-31

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1861037004 Angela L Davis Pharmacist 8520 Bash St, Indianapolis, IN 46250 2019-11-12
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1891222584 Confidential Drug LLC Pharmacy 8520 Bash St Ste D, Indianapolis, IN 46250 2017-05-12
1659813590 Occupational Health Centers of The Southwest Pa Clinic/Center 8257 Center Run Rd, Indianapolis, IN 46250 2016-11-09
1194275669 Lucina Treatment Center, LLC Internal Medicine 8140 Castleton Rd, Indianapolis, IN 46250 2016-10-09
1609126150 Joseph Lee Deck Physical Therapist 7400 Jewel Lane, Indianapolis, IN 46250 2012-09-12
1447508254 Choices Coordinated Care Solutions, Inc. Clinic/Center 7941 Castleway Drive, Indianapolis, IN 46250 2012-08-28
1568719854 Lynda L. Blackwelder, LLC Marriage & Family Therapist 4735 Statesmen Dr., Suite A, Indianapolis, IN 46250 2012-08-06
1972859452 Courtney B. Cortez Nurse Practitioner 12400 N Meridian Ste 100, Suite 500, Indianapolis, IN 46250 2012-08-02
1861761934 Kb Medical, Inc. Durable Medical Equipment & Medical Supplies 8455, Castlewood Drive, Suite J, Idianapolis, IN 46250 2011-12-20
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Taxonomy Information

Taxonomy Code 103G00000X
Grouping Behavioral Health & Social Service Providers
Classification Clinical Neuropsychologist

Taxonomy Definition

An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1497273015 Jana Beth Dykstra Clinical Neuropsychologist 355 W 16th Street Goodman Hall, Indianapolis, IN 46202 2017-09-04
1558779355 Neurobehavioral Consultants, LLC Clinical Neuropsychologist 4356 N College Ave, Indianapolis, IN 46205-1932 2014-07-24
1306170626 Elizabeth Begyn Clinical Neuropsychologist 541 Clinical Dr # Cl285, Indianapolis, IN 46202-5233 2009-09-21
1215101696 Michelle Anne Keiski Clinical Neuropsychologist 355 W 16th St Ste 4700, Indianapolis, IN 46202-2285 2008-04-17
1447477088 Robert Nolan Mckinney Clinical Neuropsychologist 2596 N Girls School Rd, Indianapolis, IN 46214-2105 2007-04-18
1003833096 Raymond W Horn Clinical Neuropsychologist 10293 N Meridian St Ste 210, Indianapolis, IN 46290-1079 2006-07-16
1255327748 Gwen C Sprehn Clinical Neuropsychologist Dept of Neurology Indiana University School of Med, 541 Clinical Drive (cl-299), Indianapolis, IN 46202 2005-09-21
1285639476 Odie L Bracy IIi Clinical Neuropsychologist 6555 Carrollton Ave, Indianapolis, IN 46220-1664 2005-06-15
1811506769 Midwest Supervision and Evaluation Clinical Neuropsychologist 450 E 96th St Ste 500, Indianapolis, IN 46240-3760 2020-07-27
1033758040 Comprehensive Neuropsychology of Indiana Clinical Neuropsychologist 10293 N Meridian St Ste 210, Indianapolis, IN 46290-1079 2019-12-23
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City INDIANAPOLIS
Zip Code 46250

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Dataset Information

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.

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