MEDICARE: SHERLY PHILEMON PSYD, MPH

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	0810008725	VA

General Provider Information

NPI Number	:	1962288159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERLY PHILEMON PSYD, MPH

Provider Business Mailing Address
First Line	:	PSC 475 BOX 1
Second Line	:
City	:	FPO
State	:	AP
Zip	:	96350-1200
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PSC 475 BOX 1
Second Line	:
City	:	FPO
State	:	AP
Zip	:	96350
Country	:	JP
Telephone Number	:	182-794-8000
Fax Number	:

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

Provider Enumeration Date	:	09/05/2023
Last Update Date	:	06/07/2026

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