MEDICARE: LESLEY FIELDS PSYD LLC

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1871150540
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LESLEY FIELDS PSYD LLC

Provider Business Mailing Address
First Line	:	361 NEWBURY ST FL 5
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-2727
Country	:	US
Telephone Number	:	857-241-3786
Fax Number	:

Provider Business Practice Location Address
First Line	:	361 NEWBURY ST FL 5
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-2727
Country	:	US
Telephone Number	:	857-241-3786
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PSYCHOLOGIST
Name	:	LESLEY FIELDS
Credential	:	PSYD
Telephone Number	:	857-241-3786

Provider Enumeration Date	:	05/28/2019
Last Update Date	:	03/11/2026

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