Provider Demographics
NPI:1982776977
Name:GREENBLATT, STEVEN HARRY (LCSW)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:HARRY
Last Name:GREENBLATT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1670 S. AMPHLETT BLVD
Mailing Address - Street 2:SUITE 214-12
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-4214
Mailing Address - Country:US
Mailing Address - Phone:650-619-1946
Mailing Address - Fax:
Practice Address - Street 1:1131 HOWARD AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-4214
Practice Address - Country:US
Practice Address - Phone:650-619-1946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS70771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical