Active NPI
Joseph Jeane-Leeman, PH.D., LP
- Clinical Neuropsychologist
- Fort Worth, TX
National Provider Identifier
1205568458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 39066
- Practice address
- 1208 W Magnolia Ave Ste 234
Fort Worth, TX 76104-8801 - Phone
- (817) 989-6312
- NPI assigned
- Jun 27, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 39066 | TX | Primary |
Addresses
Primary practice location
1208 W Magnolia Ave Ste 234
Fort Worth, TX 76104-8801
Mailing address
1208 W Magnolia Ave Ste 234
Fort Worth, TX 76104-8801
Phone (817) 989-6312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39066 | TX | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656288000000",
"number": "1205568458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1208 W MAGNOLIA AVE STE 234",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761048801",
"telephone_number": "817-989-6312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1208 W MAGNOLIA AVE STE 234",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761048801",
"telephone_number": "817-989-6312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEANE-LEEMAN",
"first_name": "JOSEPH",
"credential": "PH.D., LP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-06-27",
"last_updated": "2022-06-27",
"certification_date": "2022-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TX",
"license": "39066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.