Provider Demographics
NPI:1609955210
Name:STEINBERG, MARK ALLEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ALLEN
Last Name:STEINBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:440 HUMPHREY STREET
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907
Mailing Address - Country:US
Mailing Address - Phone:781-598-6680
Mailing Address - Fax:781-596-3669
Practice Address - Street 1:440 HUMPHREY STREET
Practice Address - Street 2:SUITE 3
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907
Practice Address - Country:US
Practice Address - Phone:781-598-6680
Practice Address - Fax:781-596-3669
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA1046841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP02942Medicare UPIN