Provider Demographics
NPI:1003207846
Name:BILLMANN, STEPHEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:BILLMANN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8118 CORPORATE WAY
Mailing Address - Street 2:SUITE #121
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-7350
Mailing Address - Country:US
Mailing Address - Phone:513-297-3455
Mailing Address - Fax:513-297-0841
Practice Address - Street 1:8118 CORPORATE WAY
Practice Address - Street 2:SUITE #121
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-7350
Practice Address - Country:US
Practice Address - Phone:513-297-3455
Practice Address - Fax:513-297-0841
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5467103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral