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DR. LEROY BURGESS PSYCHOLOGIST
NPI 1528449964
Psychologist - Health Service in South Bend, IN

Active since June 11, 2015
300 S SAINT LOUIS BLVD STE 202, SOUTH BEND, IN 46617(574) 232-1405(574) 232-0124 Get Directions Write a Review

NPPES record last updated: June 11, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Leroy Burgess Psychologist NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LEROY BURGESS PSYCHOLOGIST (NPI 1528449964) is an individual health service provider in South Bend, Indiana, licensed in Indiana (99066271A) and active in the NPI registry since June 2015.

NPPES Registry Identity

NPI1528449964
Entity TypeIndividualMale
Primary Taxonomy103TH0100X
Provider Legal NameDR. LEROY BURGESSCredential: PSYCHOLOGIST
Location Address300 S SAINT LOUIS BLVD STE 202South Bend, IN 46617-3044
Mailing Address300 S Saint Louis Blvd Ste 202South Bend, IN 46617-3044 · (574) 232-1405 · Fax (574) 232-0124
Phone(574) 232-1405
Fax(574) 232-0124
Sole ProprietorYes
Enumeration DateJune 11, 2015
✔ NPI 1528449964 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · Health ServiceBehavioral Health & Social Service Providers
Taxonomy Code103TH0100X
License✔ Licensed in IN · 99066271A
Definition
A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).
300 S SAINT LOUIS BLVD STE 202, South Bend, IN 46617
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leroy Burgess's NPI number?

The NPI number for Leroy Burgess is 1528449964. It was assigned to this individual provider in the NPPES registry on June 11, 2015.

Where is Leroy Burgess located?

Leroy Burgess practices at 300 S Saint Louis Blvd Ste 202, South Bend, IN 46617. The listed phone number is (574) 232-1405.

What is Leroy Burgess's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Health Service, with taxonomy code 103TH0100X.

When was this NPI record last updated?

The NPPES record for Leroy Burgess was last updated on June 11, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.