Provider Demographics
NPI:1417361460
Name:ARCIDIACONO, STEVEN JAMES (PHD PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:JAMES
Last Name:ARCIDIACONO
Suffix:
Gender:M
Credentials:PHD PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1655 PALM BEACH LAKES BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2203
Mailing Address - Country:US
Mailing Address - Phone:531-612-6000
Mailing Address - Fax:531-612-6098
Practice Address - Street 1:1655 PALM BEACH LAKES BLVD STE 102
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-2203
Practice Address - Country:US
Practice Address - Phone:531-612-6000
Practice Address - Fax:531-612-6098
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10133103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47037660631Medicaid
NE10026139700Medicaid