Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Leland W Petersen, CP

Individual provider Clinical Psychologist · NPI 1790902229

Leland W Petersen, CP is a Clinical Psychologist in Glen Head, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2007

Practice location Address checks out

11 Beechwood Dr
Glen Head, NY 11545-1101
Phone: (516) 671-7509
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 05430 (NY)

Record details

NPI number1790902229
Entity typeIndividual (Type 1)
GenderMale
Credentials CP
Sole proprietorYes
NPI enumeratedApril 19, 2007
Last updated in NPPESOctober 31, 2007

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