DR. LESLIE KJOSA SUTRO (NPI# 1598911679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598911679 |
| Entity Type | Individual |
| Full Name | DR. LESLIE KJOSA SUTRO |
| Other Name | LESLIE ANNE KJOSA |
| Credential | PH.D. |
| Practice Address |
41 Pacella Park Dr Randolph MA 02368-1755 |
| Practice Telephone | 7814371250 |
| Mailing Telephone | 7814371250 |
| Enumeration Date | 2008-08-08 |
| Last Update Date | 2008-08-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
8871 | MA | Behavioral Health & Social Service Providers |
| N | 103TS0200X |
Psychologist Specialization: School |
8871 | MA | Behavioral Health & Social Service Providers |
| Street Address |
41 PACELLA PARK DR |
| City | RANDOLPH |
| State | MA |
| Zip Code | 02368-1755 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356318125 | The May Institute, Inc | Psychologist | 41 Pacella Park Dr, Randolph, MA 02368-1755 | 2006-03-01 |
| 1952900227 | Manyun Xie | Counselor | 41 Pacella Park Dr, Randolph, MA 02368-1755 | 2020-10-19 |
| 1558978718 | John H Williams | Counselor | 41 Pacella Park Dr, Randolph, MA 02368-1755 | 2020-09-30 |
| 1487269593 | Phillip A Burke | Counselor | 41 Pacella Park Dr, Randolph, MA 02368-1755 | 2020-09-15 |
| 1326650797 | Nakayla C Raymond | Counselor | 41 Pacella Park Dr, Randolph, MA 02368-1755 | 2020-08-18 |
| 1508478967 | Cynthia L Riley | Behavioral Analyst | 41 Pacella Park Dr, Randolph, MA 02368-1755 | 2020-08-18 |
| 1649881954 | Johanna Dowdy | Counselor | 41 Pacella Park Dr, Randolph, MA 02368-1755 | 2020-08-11 |
| 1124643432 | Kayla Ruth Gordon | Psychologist | 41 Pacella Park Dr, Randolph, MA 02368-1755 | 2020-06-11 |
| 1013531540 | Sacha Shaw | Behavioral Analyst | 41 Pacella Park Dr, Randolph, MA 02368-1755 | 2020-06-01 |
| 1154959542 | Jon Roland | Behavioral Analyst | 41 Pacella Park Dr, Randolph, MA 02368-1755 | 2020-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962016444 | Kadiatou Djindji Bah | Behavior Technician | 75 N Main St Suite 628, Randolph, MA 02368 | 2020-09-02 |
| 1194334490 | Madison Murphy | Behavior Technician | 75 North Main Street, Ma, Suite #628, Randolph, MA 02368 | 2020-07-23 |
| 1255995049 | Daniel Joseph Bellistri | Social Worker | Daniel Bellistri, 70 Memorial Pkwy., Randolph, MA 02368 | 2019-04-26 |
| 1992291124 | Ashley Lauren Davis | Licensed Practical Nurse | 11 Mcdonnell Drive, Randolph, MA 02368 | 2018-07-11 |
| 1023503943 | Jean Rony Mesalon | Licensed Practical Nurse | 8 Reynolds Ave, Randolph, MA 02368 | 2018-06-22 |
| 1154829208 | Tatianna Lovette Hendren | Behavioral Analyst | 28 Liberty Place, Apartment C, Randolph, MA 02368 | 2018-01-24 |
| 1841709698 | Gerica Barbosa | Counselor | 37 Sarah St, Randolph, MA 02368 | 2017-09-25 |
| 1437508629 | Julie A Panchamsingh-barakat | Social Worker | 400-, 402 N Main St, Randolph, MA 02368 | 2016-06-08 |
| 1497109789 | Grace Dorcas Pokuah | Counselor | 24 Nelson Dr, #1a, Randolph, MA 02368 | 2016-04-22 |
| 1194185868 | Heavenly Home Care | Home Health | 9 William Morrison Drive, Randolph, MA 02368 | 2016-02-24 |
| Find all providers in zip 02368 | ||||
| Taxonomy Code | 103TC2200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical Child & Adolescent |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437173176 | Eric Scott Herschman | Psychologist | 2 W Hanover Ave, Suite 203, Randolph, NJ 07869-4222 | 2006-07-26 |
| 1437606498 | Omolara Oshodi | Psychologist | 44 Diauto Dr, Randolph, MA 02368-4536 | 2016-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518575786 | Eavan Miles-mason, Phd, LLC | Psychologist | 319 Peakham Rd, Sudbury, MA 01776-2757 | 2020-07-14 |
| 1184247132 | Lauren R Blakely | Psychologist | 96 Fairbanks Ave, Wellesley, MA 02481-5256 | 2020-05-26 |
| 1881220986 | Katharine Dunson Oconnell | Psychologist | 144 Forest St, Wellesley Hills, MA 02481-6832 | 2020-03-20 |
| 1710457577 | Karla Lizbet Rivas | Psychologist | 44 Mansfield St, Allston, MA 02134 | 2018-12-04 |
| 1497230684 | Marisa Katherine Glynn | Psychologist | 35 Edgar Avenue, Somerville, MA 02145 | 2018-10-03 |
| 1043706419 | Jessica Shepley | Psychologist | 72 Fox Hill Rd, Bernardston, MA 01337-9586 | 2018-07-09 |
| 1548755176 | Elizabeth F Clark | Psychologist | 16 Gleasondale Rd, Stow, MA 01775-1465 | 2018-06-26 |
| 1528552619 | Heather Duckworth Smith | Psychologist | 5 Seal Cove Ln, Hingham, MA 02043-1050 | 2018-06-21 |
| 1467946251 | Olivia Moorehead-slaughter | Psychologist | 171 Goddard Ave, Brookline, MA 02445-7412 | 2018-06-15 |
| 1710479522 | David Arnold | Psychologist | 35 Hop Brook Rd, Amherst, MA 01002-2771 | 2018-06-06 |
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| 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.