Stephen E Nassar Psy D LCSW P a

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY6228 Issued in FL

Legal business name

STEPHEN E NASSAR PSY D LCSW P A

Practice address

3684 N Wickham Rd
Suite B
Melbourne, FL 32935-2328

Phone

(321) 751-3636

Fax

(321) 751-8108

NPI assigned

Jul 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stephen Edward Nassar, PSYD, LCSW

Title

Ceo

Phone

(321) 751-3636

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1659305571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3684 N WICKHAM RD",
            "address_2": "SUITE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352328",
            "telephone_number": "321-751-3636",
            "fax_number": "321-751-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3684 N WICKHAM RD",
            "address_2": "SUITE B",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352328",
            "telephone_number": "321-751-3636",
            "fax_number": "321-751-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN E NASSAR PSY D LCSW P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "NASSAR",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-751-3636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LCSW"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY6228",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW3802",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Steininger, DPT
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• Katherine Stensland, MS, OTR/L
• Stephen Di Cerbo LMFT PA
• Stephen Hornell, MD, PA
• Stephen M Giorgianni DO PLLC
• Stephen T. Ruso, D.D.S., M.S., P.L.L.C.
• Brent Stephens, MD
• Stacyann Stephens

• Psychologist in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.

Verify at the official NPI Registry.