Provider Demographics
NPI:1790763845
Name:GREENWOOD, LEAH (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:
Last Name:GREENWOOD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 EXTON CMNS
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2452
Mailing Address - Country:US
Mailing Address - Phone:610-214-2090
Mailing Address - Fax:610-214-2091
Practice Address - Street 1:766 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2547
Practice Address - Country:US
Practice Address - Phone:610-873-2233
Practice Address - Fax:610-873-2235
Is Sole Proprietor?:No
Enumeration Date:2006-01-07
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008758L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017336770003Medicaid
PA2149091000OtherPERSONAL CHOICE
PA001662198OtherHIGHMARK
PW023042Medicare ID - Type Unspecified