Provider Demographics
NPI:1265573224
Name:SANDS, STEVEN M (PHD, DPHIL)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:SANDS
Suffix:
Gender:M
Credentials:PHD, DPHIL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BUCKINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-2220
Mailing Address - Country:US
Mailing Address - Phone:617-354-6612
Mailing Address - Fax:
Practice Address - Street 1:4 BUCKINGHAM ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-2220
Practice Address - Country:US
Practice Address - Phone:617-354-6612
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2433103TC0700X, 103TF0000X, 103T00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW02587OtherBLUE CROSS BLUE SHIELD
MAW02587OtherBLUE CROSS BLUE SHIELD