Individual provider Active NPI

Craig Evan Stephenson

  • Psychoanalyst
  • New York, NY
National Provider Identifier
1518452226
Registry record updated Jun 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
001019 Issued in NY
Practice address
25 Central Park W Apt 1N
New York, NY 10023-7210
Phone
(917) 423-5314
NPI assigned
Jun 25, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalyst 102L00000X 001019 NY Primary

Addresses

Primary practice location

25 Central Park W Apt 1N
New York, NY 10023-7210

Mailing address

785 W End Ave Apt 6C
New York, NY 10025-5451
Phone (917) 423-5336

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

State licenses

LicenseStateTypeSpecialty
001019NYMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1518452226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 W END AVE APT 6C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100255451",
            "telephone_number": "917-423-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CENTRAL PARK W APT 1N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100237210",
            "telephone_number": "917-423-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "CRAIG",
        "middle_name": "EVAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "001019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; 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.