Individual provider Active NPI

Steven Michael Daniels Jr., PH.D.

  • Psychologist
  • Greensboro, NC
National Provider Identifier
1356697171
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
102985 Issued in NC
Practice address
2006 New Garden Rd
Unit 202
Greensboro, NC 27410-2566
Phone
(336) 288-6440
NPI assigned
Jul 30, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 102985 NC Primary

Addresses

Primary practice location

2006 New Garden Rd
Unit 202
Greensboro, NC 27410-2566

Mailing address

1201 Flanders St
Garner, NC 27529-4406
Phone (919) 906-2891

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20130415000139 NC Practitioner - Clinical Psychologist 9537305776 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8961 Harvest Oaks Dr
Suite 205
Raleigh, NC 27615-2140
Phone (919) 906-2891

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
102985NCMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven M Daniels Jr PHD PLLC Psychologist CurrentSince Feb 28, 2013 Accepting new patients
Irving a. Lugo, M.D., P.a. PastSince Aug 15, 2011 Accepting new patients

Locations

901 Paverstone Dr
Raleigh, NC 27615
Phone (919) 818-4284

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1356697171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 FLANDERS ST",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275294406",
            "telephone_number": "919-906-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 NEW GARDEN RD",
            "address_2": "UNIT 202",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102566",
            "telephone_number": "336-288-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIELS",
        "first_name": "STEVEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "102985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.