Provider Demographics
NPI:1801089305
Name:PARKER, STEVEN (DSW)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:PARKER
Suffix:
Gender:M
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5775 MOSHOLU AVE
Mailing Address - Street 2:APT 4-J
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2217
Mailing Address - Country:US
Mailing Address - Phone:718-920-9581
Mailing Address - Fax:
Practice Address - Street 1:5775 MOSHOLU AVE
Practice Address - Street 2:APT 4-J
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-2217
Practice Address - Country:US
Practice Address - Phone:718-920-9581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR020271101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health