Individual provider Active NPI

Monique Levermore, PH.D.

  • Clinical Psychologist
  • Palmetto Bay, FL
National Provider Identifier
1790918456
Registry record updated Aug 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY 0005628 Issued in FL
Practice address
15715 S Dixie Hwy
Suite 404
Palmetto Bay, FL 33157-1800
Phone
(786) 293-0922
Fax
(786) 293-0923
NPI assigned
Aug 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY 0005628 FL Primary

Addresses

Primary practice location

15715 S Dixie Hwy
Suite 404
Palmetto Bay, FL 33157-1800

Mailing address

15715 S Dixie Hwy
Suite 404
Palmetto Bay, FL 33157-1800
Phone (786) 293-0922

Other identifiers 1

IdentifierTypeStateIssuer
54205OtherFLBLUE CROSS BLUE SHIELD

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY 0005628FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Levermore Psychological Services, P.a. Clinical PastSince Nov 8, 2004 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1790918456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15715 S DIXIE HWY",
            "address_2": "SUITE 404",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571800",
            "telephone_number": "786-293-0922",
            "fax_number": "786-293-0923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15715 S DIXIE HWY",
            "address_2": "SUITE 404",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331571800",
            "telephone_number": "786-293-0922",
            "fax_number": "786-293-0923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVERMORE",
        "first_name": "MONIQUE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-28",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 0005628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "54205",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; 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.