Provider Demographics
NPI:1821169095
Name:PRASINOS, STEVEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:PRASINOS
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 1:39 SHERMAN HILL RD
Mailing Address - Street 2:SUITE C-202B
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-3650
Mailing Address - Country:US
Mailing Address - Phone:203-266-4003
Mailing Address - Fax:203-266-4003
Practice Address - Street 1:39 SHERMAN HILL RD
Practice Address - Street 2:SUITE C-202B
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-3650
Practice Address - Country:US
Practice Address - Phone:203-266-4003
Practice Address - Fax:203-266-4003
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1079103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP693836OtherOXFORD
CT060001079CT01OtherANTHEM
CT4601583OtherAETNA