Provider Demographics
NPI:1831882075
Name:ETIENNE, STEVEN (MSW)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:ETIENNE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 PARK AVE APT 22B
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6231
Mailing Address - Country:US
Mailing Address - Phone:845-893-2842
Mailing Address - Fax:
Practice Address - Street 1:2488 GRAND CONCOURSE FL 2
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5203
Practice Address - Country:US
Practice Address - Phone:718-881-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical