Healthcare Provider Details

I. General information

NPI: 1336649623
Provider Name (Legal Business Name): LEANNA JEAN PITTSENBARGER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

454 E MAIN ST STE 240
COLUMBUS OH
43215-5380
US

IV. Provider business mailing address

28 TANGLEWOOD DR
DELAWARE OH
43015-1238
US

V. Phone/Fax

Practice location:
  • Phone: 614-636-4779
  • Fax:
Mailing address:
  • Phone: 937-869-4325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberP.08464
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: