Sue Levy PSYD LCSW PA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW0002513 Issued in FL

Legal business name

SUE LEVY PSYD LCSW PA

Practice address

3959 S Nova Road
BLDG B Suite 23
Port Orange, FL 32127-9229

Phone

(386) 253-8439

Fax

(386) 253-8439

NPI assigned

Dec 14, 2007

Organization subpart

No

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

Authorized official

Name

Sue Levy, PSYD LCSWNPI 1093747313

Title

President/Psychologist

Phone

(386) 253-8439

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sue Levy, PSYD LCSW

  • Clinical Social Worker
  • Port Orange, FL
  • NPI 1093747313
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646697600000",
    "number": "1124201983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 S NOVA ROAD",
            "address_2": "BLDG B SUITE 23",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279229",
            "telephone_number": "386-253-8439",
            "fax_number": "386-253-8579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 S NOVA ROAD",
            "address_2": "BLDG B SUITE 23",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279229",
            "telephone_number": "386-253-8439",
            "fax_number": "386-253-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUE LEVY PSYD LCSW PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A",
        "authorized_official_last_name": "LEVY",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "PRESIDENT/PSYCHOLOGIST",
        "authorized_official_telephone_number": "386-253-8439",
        "authorized_official_credential": "PSYD LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW0002513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1093747313",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "768630700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denise Strickland
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• Suncoast Vein & Vascular Clinic PLC
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• Edward Supinski, MD
• Surgery Center of Volusia, LLC

• Clinical Social Worker in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.