Provider Demographics
NPI:1427076991
Name:LEITE, JOHN SHERWOOD (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SHERWOOD
Last Name:LEITE
Suffix:
Gender:M
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:PO BOX 341065
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38184-1065
Mailing Address - Country:US
Mailing Address - Phone:901-385-2342
Mailing Address - Fax:901-382-0140
Practice Address - Street 1:8134 COUNTRY VILLAGE DR
Practice Address - Street 2:SUITE 102
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-2029
Practice Address - Country:US
Practice Address - Phone:901-756-8398
Practice Address - Fax:901-756-8701
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP726103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist