Provider Demographics
NPI:1568462232
Name:SIMMINGER, STEVEN E (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:SIMMINGER
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 1:10 COURTNEY LN
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-2145
Mailing Address - Country:US
Mailing Address - Phone:610-565-7703
Mailing Address - Fax:610-565-2039
Practice Address - Street 1:10 COURTNEY LN
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2145
Practice Address - Country:US
Practice Address - Phone:610-565-7703
Practice Address - Fax:610-565-2039
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 002213L103T00000X, 103TC0700X, 103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
750OtherASPPB
21497OtherNATIONAL REGISTER
PAPS 002213LOtherPSYCHOLOGIST LICENSE
750OtherASPPB
PAPS 002213LOtherPSYCHOLOGIST LICENSE