Provider Demographics
NPI:1376650259
Name:PARO, STEVEN NELSON (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:NELSON
Last Name:PARO
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3220 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:ENDWELL
Mailing Address - State:NY
Mailing Address - Zip Code:13760-5758
Mailing Address - Country:US
Mailing Address - Phone:607-754-4520
Mailing Address - Fax:607-754-4021
Practice Address - Street 1:3220 PEARL ST
Practice Address - Street 2:
Practice Address - City:ENDWELL
Practice Address - State:NY
Practice Address - Zip Code:13760-5758
Practice Address - Country:US
Practice Address - Phone:607-754-4520
Practice Address - Fax:607-754-4021
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR021454-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR021454OtherLICENSE
NYS40858Medicare UPIN