Provider Demographics
NPI:1174689202
Name:PHILIPSON, STEPHEN (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:PHILIPSON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3006
Mailing Address - Country:US
Mailing Address - Phone:718-499-7284
Mailing Address - Fax:
Practice Address - Street 1:497 4TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3006
Practice Address - Country:US
Practice Address - Phone:718-499-7284
Practice Address - Fax:718-499-7284
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO1708511041C0700X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
G87809OtherVBH
0028559OtherGHI