Individual
MR. JOHN J LEAHY
Active
Individual
MR. JOHN J LEAHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EDD
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5084
MA
103TH0100X
Health Service Psychologist
5084
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891227
—
MA
01
—
6100041
EVERCARE PROVIDER NUMBER
MA
01
—
W04815
BCBS PROVIDER NUMBER
MA
Enumeration date
10/16/2006
Last updated
02/26/2019
Update your record
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