Provider Demographics
NPI:1346426624
Name:STERN, JEFFREY JOEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JOEL
Last Name:STERN
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 1:29290 WYNDHAM CT
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-1859
Mailing Address - Country:US
Mailing Address - Phone:248-851-3996
Mailing Address - Fax:
Practice Address - Street 1:29290 WYNDHAM CT
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1859
Practice Address - Country:US
Practice Address - Phone:248-851-3996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5750103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist