Provider Demographics
NPI:1679571608
Name:STEINBERG, KAREN (PHD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:STEINBERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-2212
Mailing Address - Country:US
Mailing Address - Phone:860-679-7503
Mailing Address - Fax:860-679-1610
Practice Address - Street 1:65 KANE ST
Practice Address - Street 2:CHILD & ADOLECENCE PSYCHIATRY
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-2110
Practice Address - Country:US
Practice Address - Phone:860-523-3745
Practice Address - Fax:860-523-3736
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002015103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTD400011665OtherMEDICARE PTAN FOR UMG
CT4158904Medicaid
CTD400011664OtherMEDICARE PTAN FOR JDH