Steven J Ceresnie PHD PC

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

6301002659 Issued in MI

Legal business name

STEVEN J CERESNIE PHD PC

Practice address

199 N Main St
Plymouth, MI 48170-1272

Phone

(734) 453-9290

Fax

(734) 453-9293

NPI assigned

Sep 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Steven J Ceresnie, PHDNPI 1942475348

Title

Owner

Phone

(734) 453-9290

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven J. Ceresnie, PH.D.

  • Clinical Child & Adolescent Psychologist
  • Plymouth, MI
  • NPI 1942475348
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225065600000",
    "number": "1013166578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 N MAIN ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701272",
            "telephone_number": "734-453-9290",
            "fax_number": "734-453-9293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 N MAIN ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701272",
            "telephone_number": "734-453-9290",
            "fax_number": "734-453-9293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN J CERESNIE PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-10-27",
        "status": "A",
        "authorized_official_last_name": "CERESNIE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-453-9290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301002659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "620H24558",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cody Stephens
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• Stacey Stephens
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• Katherine Stetson Macconnachie, MOT
• Valerie Stevens, LMSW
• Grace Stewart
• La'Niya Stewart
• Margaret Stiefel
• Jill Kristin Stiles

• Clinical Child & Adolescent Psychologist in Plymouth, MI
• Providers in Plymouth, MI by specialty
• Clinical Child & Adolescent Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.