Individual provider Active NPI

Sheryl Leytham, PHD

  • Psychologist
  • Charleston, SC
National Provider Identifier
1891887162
Registry record updated Nov 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
00583 Issued in IA
Practice address
109 Bee St
Charleston, SC 29401-5703
Phone
(843) 577-5011
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 00583 IA Primary

Addresses

Primary practice location

109 Bee St
Charleston, SC 29401-5703

Mailing address

109 Bee St
Charleston, SC 29401-5703
Phone (843) 577-5011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220923001220 IL Practitioner - Clinical Psychologist 1658343280 Reassigns benefits to 1 organization
I20230929000019 FL Practitioner - Clinical Psychologist 1658343280 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Merion Square Road Medical PCGroup PAC ID 0446605422, 22 clinicians

Practice addresses (Care Compare)

6421 N Florida Ave
Suite D 1149
Tampa, FL 33604-6007
Phone (646) 598-8338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
00583IAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Merion Square Road Medical PC CurrentSince Aug 1, 2024 Accepting new patients
Drlullaby LLC CurrentSince Aug 1, 2022 Accepting new patients
Drlullaby LLC CurrentSince Aug 1, 2022 Accepting new patients
Mercy Clinics, Inc. Past Accepting new patients

Locations

9701 NE 2nd Ave
Miami Shores, FL 33138
Phone (645) 201-9707

6421 N Florida Ave
Tampa, FL 33604
Phone (813) 305-2867

3343 Peachtree Rd NE
Ste 145
Atlanta, GA 30326
Phone (276) 663-0598

64 Central Ave W
Edgewater, MD 21037
Phone (240) 718-8255

2136 Ford Pkwy
Ste 5416
Saint Paul, MN 55116

4723 Fayetteville Rd
Durham, NC 27713

1181 Nixon Dr
Moorestown, NJ 08057
Phone (267) 235-0059

31 S Main St
Ste 435
Dayton, OH 45402

6059 Allentown Blvd
Harrisburg, PA 17112
Phone (717) 208-2215

3333 Preston Rd
Ste 300
Frisco, TX 75034
Phone (410) 449-9142

2003 Plank Rd
Fredericksburg, VA 22401
Phone (540) 693-0644

Interoperability endpoints

  • Direct secure messaging: sheryl.leytham.1@30520.direct.athenahealth.com

Organizations & group practices 4

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1891887162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BEE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294015703",
            "telephone_number": "843-577-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BEE ST",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294015703",
            "telephone_number": "843-577-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYTHAM",
        "first_name": "SHERYL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IA",
            "license": "00583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.