Steven Dallas Eberth, OTD, OTRL, CDP, CFPS

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

5201003590 Issued in MI

Practice address

3905 Lorraine Path
Saint Joseph, MI 49085-8630

Phone

(269) 428-1111

NPI assigned

Aug 19, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1346072162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 686",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490900686",
            "telephone_number": "269-720-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 LORRAINE PATH",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490858630",
            "telephone_number": "269-428-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBERTH",
        "first_name": "STEVEN",
        "middle_name": "DALLAS",
        "credential": "OTD, OTRL, CDP, CFPS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "MI",
            "license": "5201003590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Lischer Dwan
• Karen J Dyer, M.D.
• Larisa Dyer, DO
• Brian J Dykstra, MD
• Julie Earle, LLCSW
• Emil Ethan Ebner, DO
• Kari Elizabeth Eckert
• Ny'Ja Eddie
• Hillary Nicole Edgerly, NP
• Edgewater Family Health, PLC

• Gerontology Occupational Therapist in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Gerontology Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.