Healthcare Provider Details

I. General information

NPI: 1235412396
Provider Name (Legal Business Name): LEAH ELIZABETH MORTON PSYD, HSPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 07/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9240 N MERIDIAN ST SUITE 320
INDIANAPOLIS IN
46260-1880
US

IV. Provider business mailing address

152 S 9TH ST
NOBLESVILLE IN
46060-2619
US

V. Phone/Fax

Practice location:
  • Phone: 317-844-7489
  • Fax:
Mailing address:
  • Phone: 317-572-9393
  • Fax: 317-572-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20042502A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: