Active NPI
Kevin Paul Stevens, PH.D.
- Clinical Psychologist
- Selden, NY
National Provider Identifier
1467735100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 014112-1
- Practice address
- 1305 Middle Country Rd
Selden, NY 11784-2554 - Phone
- (631) 921-6082
- NPI assigned
- Sep 20, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | 014112-1 | NY | |
| Clinical Psychologist | 103TC0700X | 014112-1 | NY | Primary |
Addresses
Primary practice location
1305 Middle Country Rd
Selden, NY 11784-2554
Mailing address
40 Riviera Dr
Selden, NY 11784-1766
Phone (631) 921-6082
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014112-1 | NY | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317081600000",
"number": "1467735100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 RIVIERA DR",
"city": "SELDEN",
"state": "NY",
"postal_code": "117841766",
"telephone_number": "631-921-6082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1305 MIDDLE COUNTRY RD",
"city": "SELDEN",
"state": "NY",
"postal_code": "117842554",
"telephone_number": "631-921-6082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEVENS",
"first_name": "KEVIN",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-20",
"last_updated": "2011-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "NY",
"license": "014112-1",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "014112-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Selden, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.