Provider Demographics
NPI:1891710422
Name:LEVITUS, SHERI A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHERI
Middle Name:A
Last Name:LEVITUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32549-0388
Mailing Address - Country:US
Mailing Address - Phone:850-830-6824
Mailing Address - Fax:850-301-0671
Practice Address - Street 1:68 SW BEAL PARKWAY
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548
Practice Address - Country:US
Practice Address - Phone:850-243-7035
Practice Address - Fax:850-243-8529
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW3602103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ6445BMedicare ID - Type Unspecified