Provider Demographics
NPI:1790001030
Name:SEGAL, STEVEN MICHEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MICHEL
Last Name:SEGAL
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 1:3625 AQUETONG RD
Mailing Address - Street 2:
Mailing Address - City:CARVERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18913-9701
Mailing Address - Country:US
Mailing Address - Phone:215-297-5952
Mailing Address - Fax:215-297-5421
Practice Address - Street 1:3625 AQUETONG RD
Practice Address - Street 2:
Practice Address - City:CARVERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18913-9701
Practice Address - Country:US
Practice Address - Phone:215-297-5952
Practice Address - Fax:215-297-5421
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2010-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003486L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist