Provider Demographics
NPI:1659683795
Name:LEE, STEVEN MERRIAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MERRIAM
Last Name:LEE
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 1:40 SCHUYLER RD
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-3904
Mailing Address - Country:US
Mailing Address - Phone:845-353-1140
Mailing Address - Fax:845-353-1141
Practice Address - Street 1:99 MAIN ST
Practice Address - Street 2:SUITE 320
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3109
Practice Address - Country:US
Practice Address - Phone:914-582-6725
Practice Address - Fax:845-353-1141
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018548-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist