Provider Demographics
NPI:1689342024
Name:DEGELSMITH, STEVEN PHILLIP (PHD LMFT)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:PHILLIP
Last Name:DEGELSMITH
Suffix:
Gender:M
Credentials:PHD LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9708 GLADBECK AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-1923
Mailing Address - Country:US
Mailing Address - Phone:818-701-9260
Mailing Address - Fax:
Practice Address - Street 1:9708 GLADBECK AVE
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-1923
Practice Address - Country:US
Practice Address - Phone:818-701-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21322106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist