Provider Demographics
NPI:1548329477
Name:BECKWITH, LESLI (PHD)
Entity type:Individual
Prefix:DR
First Name:LESLI
Middle Name:
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 NEW HIGHWAY 96 WEST
Mailing Address - Street 2:P.O. BOX 21
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064
Mailing Address - Country:US
Mailing Address - Phone:615-346-2888
Mailing Address - Fax:615-435-3227
Practice Address - Street 1:1310 24TH AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212
Practice Address - Country:US
Practice Address - Phone:615-346-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2713103TC0700X
CAPSY16712103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical