Provider Demographics
NPI:1922406065
Name:STERN, RICHARD S (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:STERN
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 1:6833 WAYNE AVE
Mailing Address - Street 2:MOUNT AIRY COUNSELING CENTER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119
Mailing Address - Country:US
Mailing Address - Phone:215-888-7785
Mailing Address - Fax:
Practice Address - Street 1:6833 WAYNE AVE
Practice Address - Street 2:MOUNT AIRY COUNSELING CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-3423
Practice Address - Country:US
Practice Address - Phone:215-888-7785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 015389103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent