Active NPI
Walter Stephaniv, PHD
- Clinical Psychologist
- Amherst, MA
National Provider Identifier
1942245667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6361
- Practice address
- 6 University Dr Ste 206 PMB 115
Amherst, MA 01002-2265 - Phone
- (413) 772-1370
- NPI assigned
- Jun 17, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6361 | MA | Primary |
Addresses
Primary practice location
6 University Dr Ste 206 PMB 115
Amherst, MA 01002-2265
Mailing address
6 University Dr Ste 206 PMB 115
Amherst, MA 01002-2265
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 |
|---|---|---|---|
| 6361 | MA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942245667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 UNIVERSITY DR STE 206 PMB 115",
"city": "AMHERST",
"state": "MA",
"postal_code": "010022265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 UNIVERSITY DR STE 206 PMB 115",
"city": "AMHERST",
"state": "MA",
"postal_code": "010022265",
"telephone_number": "413-772-1370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHANIV",
"first_name": "WALTER",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "6361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amherst, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.