Provider Demographics
NPI:1851316582
Name:STERN, W SYDNEY (EDD)
Entity Type:Individual
Prefix:DR
First Name:W
Middle Name:SYDNEY
Last Name:STERN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2419
Mailing Address - Country:US
Mailing Address - Phone:413-586-3942
Mailing Address - Fax:413-585-9845
Practice Address - Street 1:374 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2419
Practice Address - Country:US
Practice Address - Phone:413-586-3942
Practice Address - Fax:413-585-9845
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4471103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW04391-68Medicare ID - Type UnspecifiedPSYCHOLOGIST