Provider Demographics
NPI:1225062235
Name:HENTOFF, STEVEN CHARLES (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:CHARLES
Last Name:HENTOFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MAIN ST
Mailing Address - Street 2:SUITE 305A
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4525
Mailing Address - Country:US
Mailing Address - Phone:508-651-3309
Mailing Address - Fax:508-651-3306
Practice Address - Street 1:20 MAIN ST
Practice Address - Street 2:SUITE 305A
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4525
Practice Address - Country:US
Practice Address - Phone:508-651-3309
Practice Address - Fax:508-651-3306
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3868103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0516341Medicaid
MAW03849Medicare ID - Type Unspecified
MA0516341Medicaid