Provider Demographics
NPI:1790958379
Name:WELCH, STEVEN PAUL (LCSW-R,ACSW, CASAC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:PAUL
Last Name:WELCH
Suffix:
Gender:M
Credentials:LCSW-R,ACSW, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BELLAMY LOOP
Mailing Address - Street 2:SUITE #15D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10475-3726
Mailing Address - Country:US
Mailing Address - Phone:914-589-3168
Mailing Address - Fax:
Practice Address - Street 1:19 W 34TH ST PH
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3006
Practice Address - Country:US
Practice Address - Phone:212-947-7111
Practice Address - Fax:212-239-0948
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-03
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO41877-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA300032724Medicare PIN