Active NPI
Svetlana Stepukhovich, PH.D.
- Clinical Psychologist
- Setauket, NY
National Provider Identifier
1538476122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 019988
- Practice address
- 28 Jones St
Suite 203
Setauket, NY 11733 - Phone
- (917) 830-5003
- Fax
- (631) 209-5033
- NPI assigned
- Sep 3, 2010
- Last updated
- Jan 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | |||
| Clinical Psychologist | 103TC0700X | 019988 | NY | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 019988 | NY | |
| Family Psychologist | 103TF0000X | 019988 | NY |
Addresses
Primary practice location
28 Jones St
Suite 203
Setauket, NY 11733
Mailing address
2 N Ridge Rd
Setauket, NY 11733
Phone (631) 312-4914
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective May 15, 2017 through May 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1538476122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 N RIDGE RD",
"city": "SETAUKET",
"state": "NY",
"postal_code": "11733",
"telephone_number": "631-312-4914",
"fax_number": "631-209-5033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28 JONES ST",
"address_2": "SUITE 203",
"city": "SETAUKET",
"state": "NY",
"postal_code": "11733",
"telephone_number": "917-830-5003",
"fax_number": "631-209-5033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPUKHOVICH",
"first_name": "SVETLANA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-03",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "019988",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "NY",
"license": "019988",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "NY",
"license": "019988",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Setauket, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.