Provider Demographics
NPI:1245448216
Name:DEAN, STEPHEN ANTHONY (PHD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:ANTHONY
Last Name:DEAN
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 1:1369 MARKET AVE N
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44714-2611
Mailing Address - Country:US
Mailing Address - Phone:330-455-2145
Mailing Address - Fax:330-455-0131
Practice Address - Street 1:1369 MARKET AVE N
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44714-2611
Practice Address - Country:US
Practice Address - Phone:330-455-2145
Practice Address - Fax:330-455-0131
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5186103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist