Bruce A. Leeson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY RO 269 Issued in MO

Practice address

Evans Army Community Hospital
Embedded Behavioral Health Team 5, BLDG 1226
Ft. Carson, CO 80913

Phone

(719) 503-7701

Fax

(719) 526-8770

NPI assigned

Jul 26, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1811910920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E WILLAMETTE AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033030",
            "telephone_number": "816-304-4061",
            "fax_number": "719-526-8770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EVANS ARMY COMMUNITY HOSPITAL",
            "address_2": "EMBEDDED BEHAVIORAL HEALTH TEAM 5, BLDG 1226",
            "city": "FT. CARSON",
            "state": "CO",
            "postal_code": "80913",
            "telephone_number": "719-503-7701",
            "fax_number": "719-526-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEESON",
        "first_name": "BRUCE",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "PY RO 269",
            "primary": true
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL REGISTER OF HEALTHCARE PROVIDERS IN PSYCHOLOGY",
            "identifier": "50331",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronald Norman Leavitt, O.D.
• Emily M Leclair, CNM
• Katherine Elizabeth Ledlie, PSY.D.
• Jungsu Lee, APRN
• Mark Kiwon Lee, RPH
• Cara Leonard
• Journi M Leonguerrero
• Christine Levy, R.D
• Talisha Lewis-Wooden
• Harland G Lewis Jr., DDS

• Clinical Psychologist in Ft. Carson, CO
• Providers in Ft. Carson, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.