MEDICARE: DR. CHERYL PAULA LEVIN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2117	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30514	OTHER	MA	NATIONAL REGISTER

General Provider Information

NPI Number	:	1720177587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL PAULA LEVIN PH.D.

Provider Business Mailing Address
First Line	:	916 REGAL MANOR WAY
Second Line	:
City	:	SUN CITY CTR
State	:	FL
Zip	:	33573-6580
Country	:	US
Telephone Number	:	617-396-4695
Fax Number	:	148-478-4011

Provider Business Practice Location Address
First Line	:	916 REGAL MANOR WAY
Second Line	:
City	:	SUN CITY CTR
State	:	FL
Zip	:	33573-6580
Country	:	US
Telephone Number	:	617-396-4695
Fax Number	:	148-478-4011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	06/24/2013

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