Provider Demographics
NPI:1619281318
Name:ROLLINGS, LEIGH IVY (MA)
Entity Type:Individual
Prefix:MS
First Name:LEIGH
Middle Name:IVY
Last Name:ROLLINGS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 FREDERICK ABBOTT WAY
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-3131
Mailing Address - Country:US
Mailing Address - Phone:617-912-7782
Mailing Address - Fax:
Practice Address - Street 1:1 FREDERICK ABBOTT WAY
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-7992
Practice Address - Country:US
Practice Address - Phone:774-777-3125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA1851484505.101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health