Provider Demographics
NPI:1497914469
Name:STEINBRUNNER, PEGGY V (PSYD)
Entity Type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:V
Last Name:STEINBRUNNER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:PEGGY
Other - Middle Name:V
Other - Last Name:NAVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:5045 RIVERVIEW RD
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:PA
Mailing Address - Zip Code:15537
Mailing Address - Country:US
Mailing Address - Phone:814-285-1018
Mailing Address - Fax:814-254-4170
Practice Address - Street 1:16 WATER STREET
Practice Address - Street 2:STE 101
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537
Practice Address - Country:US
Practice Address - Phone:814-283-5535
Practice Address - Fax:814-254-4170
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017564103TC0700X, 103T00000X
390200000X, 101Y00000X
MD0547103T00000X
FLPY9601103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103289532-0001Medicaid