Steven R Patrick, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3396 Issued in AZ

Practice address

617 N Humphreys St
Suite 101
Flagstaff, AZ 86001-3063

Phone

(928) 779-3783

Fax

(928) 773-1150

NPI assigned

Mar 15, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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

• Anxiety Disorders and Medical Psychology Treatment Center, P.C.

  • Clinical Psychologist
  • Flagstaff, AZ
  • NPI 1518141985
  NPD (past)
• Larry Charles Stevens, PH.D., P.C.

  • Health Psychologist
  • Flagstaff, AZ
  • NPI 1417197666

  Clinical

  NPD (past)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1396714192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 N HUMPHREYS ST STE 101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013063",
            "telephone_number": "928-779-3783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 N HUMPHREYS ST",
            "address_2": "SUITE 101",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860013063",
            "telephone_number": "928-779-3783",
            "fax_number": "928-773-1150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "STEVEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-15",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3396",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "533390",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Grace Pastor
• Janie Faith Pastorin
• Candace Berlynn Patel, FNP-BC
• Ian Mark Patience, MD
• Patrick Padrnos O.D. P.C. (Flagstaff Vision)
• Susan K Patrick, PSY.D.
• Kelly Patterson, PA-S
• Penni L Patterson, LCSW
• Cody D. Patton, DO
• Paul D Whitney DDS PC (Country Club Dental Flagstaff)

• Clinical Psychologist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Clinical Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.