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Organization
SUE LEVY PSYD LCSW PA
Active
Organization
SUE LEVY PSYD LCSW PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUE LEVY PSYD LCSW (PRESIDENT/PSYCHOLOGIST)
(386) 253-8439
Entity
Organization
Contact information
Practice address
3959 S NOVA ROAD, BLDG B SUITE 23, PORT ORANGE, FL 32127-9229
(386) 253-8439
(386) 253-8439
Mailing address
3959 S NOVA ROAD, BLDG B SUITE 23, PORT ORANGE, FL 32127-9229
(386) 253-8439
(386) 253-8579
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW0002513
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093747313
INDIVIDUAL NPI
FL
05
—
768630700
—
FL
Enumeration date
12/14/2007
Last updated
03/08/2022
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