Provider Demographics
NPI:1518045582
Name:ISENBERG, STEVEN JOEL (EDD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JOEL
Last Name:ISENBERG
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-8406
Mailing Address - Country:US
Mailing Address - Phone:781-648-1848
Mailing Address - Fax:978-371-4997
Practice Address - Street 1:259 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8406
Practice Address - Country:US
Practice Address - Phone:781-648-1848
Practice Address - Fax:978-371-4997
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3027103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1018190OtherFALLON HEALTHCARE
MAW03256OtherBLUE CROSS BLUE SHIELD
MAW03256Medicare ID - Type Unspecified