Stephen J. Antonello, Incorporated

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP1390 Issued in MN

Legal business name

STEPHEN J. ANTONELLO, INCORPORATED

Practice address

66 Thompson Ave E
Suite 102
West St Paul, MN 55118-3184

Phone

(651) 688-2335

Fax

(651) 688-2669

NPI assigned

Sep 21, 2006

Last updated

Jan 30, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Stephen John Antonello, PH.D.NPI 1760548366

Title

Licensed Psychologist

Phone

(651) 688-2335

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephen John Antonello, PH.D.

  • Clinical Psychologist
  • West St Paul, MN
  • NPI 1760548366
  Medicare reassignment NPD Authorized official
• Judy Lee Antonello, PH.D.

  • Clinical Psychologist
  • West St Paul, MN
  • NPI 1235238049
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485734400000",
    "number": "1326147133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 DEER TRAIL PT",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551182750",
            "telephone_number": "651-688-2335",
            "fax_number": "651-688-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 THOMPSON AVE E",
            "address_2": "SUITE 102",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551183184",
            "telephone_number": "651-688-2335",
            "fax_number": "651-688-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN J. ANTONELLO, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2017-01-30",
        "status": "A",
        "authorized_official_last_name": "ANTONELLO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "651-688-2335",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP1390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin P Sovich
• John C Spencer, OD
• St. Paul Opticians, Inc.
• Jennifer Steiner
• Andrea Stelter, MS, ATC, ATR
• Janine Rose Stiles, CPM
• Stillwater Dentistry PLLC
• Stoffels Chiropractic Office LTD
• Suite Living Senior Care of West St Paul
• Supervalu Pharmacies Inc (Cub Pharmacy)

• Clinical Psychologist in West St Paul, MN
• Providers in West St Paul, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2017; 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.