Provider Demographics
NPI:1336162098
Name:STEIN, ANETTA BETTY
Entity Type:Individual
Prefix:MS
First Name:ANETTA
Middle Name:BETTY
Last Name:STEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:CORTLANDT MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10567-5227
Mailing Address - Country:US
Mailing Address - Phone:914-552-5490
Mailing Address - Fax:
Practice Address - Street 1:280 N CENTRAL AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1832
Practice Address - Country:US
Practice Address - Phone:914-552-5490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000666-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health