Individual provider Active NPI

Steven Stern, PSY.D.

  • Psychologist
  • Portland, ME
National Provider Identifier
1174652408
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS1128 Issued in ME
Practice address
217 Commercial St
Suite 203
Portland, ME 04101-4679
Phone
(207) 775-3085
NPI assigned
Mar 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS1128 ME Primary
Psychologist 103T00000X IL

Addresses

Primary practice location

217 Commercial St
Suite 203
Portland, ME 04101-4679

Mailing address

217 Commercial St
Suite 203
Portland, ME 04101-4679
Phone (207) 775-3085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
071003158ILMDPsychologist
PS1128MEMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174652408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 COMMERCIAL ST",
            "address_2": "SUITE 203",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014679",
            "telephone_number": "207-775-3085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 COMMERCIAL ST",
            "address_2": "SUITE 203",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014679",
            "telephone_number": "207-775-3085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STERN",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS1128",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.