MEDICARE: DR. ADRIENNE DIONE LECA PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY1000370	DC
2	103TC2200X	Clinical Child & Adolescent Psychologist	PSY1000370	DC
3	103TC2200X	Clinical Child & Adolescent Psychologist	06679	MD
4	103TC0700X	Clinical Psychologist	06679	MD

General Provider Information

NPI Number	:	1427281054
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADRIENNE DIONE LECA PSY.D.

Provider Business Mailing Address
First Line	:	11710 ELLINGTON DR
Second Line	:
City	:	BELTSVILLE
State	:	MD
Zip	:	20705-1307
Country	:	US
Telephone Number	:	254-449-2895
Fax Number	:

Provider Business Practice Location Address
First Line	:	11710 ELLINGTON DR
Second Line	:
City	:	BELTSVILLE
State	:	MD
Zip	:	20705-1307
Country	:	US
Telephone Number	:	254-449-2895
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2009
Last Update Date	:	02/17/2024

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