Provider Demographics
NPI:1235551169
Name:STEVEN DAVID PH.D. & ASSOCIATES, A PROFESSIONAL PSYCHOLOGY CORPORATION
Entity Type:Organization
Organization Name:STEVEN DAVID PH.D. & ASSOCIATES, A PROFESSIONAL PSYCHOLOGY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVID
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:323-401-0493
Mailing Address - Street 1:143 ROUTE 6A
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH PORT
Mailing Address - State:MA
Mailing Address - Zip Code:02675-1713
Mailing Address - Country:US
Mailing Address - Phone:323-401-0493
Mailing Address - Fax:508-744-7205
Practice Address - Street 1:143 ROUTE 6A
Practice Address - Street 2:
Practice Address - City:YARMOUTH PORT
Practice Address - State:MA
Practice Address - Zip Code:02675-1713
Practice Address - Country:US
Practice Address - Phone:323-401-0493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-12
Last Update Date:2023-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22018103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty