Individual provider Active NPI

Brian C Stevens, PH.D.

  • Clinical Psychologist
  • New York, NY
National Provider Identifier
1043374697
Registry record updated Jul 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
017034 Issued in NY
Practice address
420 W 24TH St
Ste 1B
New York, NY 10011-1325
Phone
(212) 260-8566
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 017034 NY Primary

Addresses

Primary practice location

420 W 24TH St
Ste 1B
New York, NY 10011-1325

Mailing address

309 E 5TH St
Apt 1
New York, NY 10003-8825
Phone (212) 260-8566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070216000613 NY Practitioner - Clinical Psychologist 9436251782 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

420 W 24TH St
1B
New York, NY 10011-1333
Phone (212) 260-8566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185494400000",
    "number": "1043374697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E 5TH ST",
            "address_2": "APT 1",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100038825",
            "telephone_number": "212-260-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W 24TH ST",
            "address_2": "STE 1B",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100111325",
            "telephone_number": "212-260-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "BRIAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "017034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.