Provider Demographics
NPI:1790060564
Name:PUENTE, STEVEN WILLIAM (LMSW)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:WILLIAM
Last Name:PUENTE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 E 103RD ST
Mailing Address - Street 2:#27
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5309
Mailing Address - Country:US
Mailing Address - Phone:801-918-1779
Mailing Address - Fax:
Practice Address - Street 1:124 E 103RD ST
Practice Address - Street 2:#27
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5309
Practice Address - Country:US
Practice Address - Phone:801-918-1779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084665-1101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)