Provider Demographics
NPI:1982786547
Name:BARILLE, STEVEN ROGER (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ROGER
Last Name:BARILLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6318 EASTONDALE RD
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4105
Mailing Address - Country:US
Mailing Address - Phone:440-449-5682
Mailing Address - Fax:
Practice Address - Street 1:6318 EASTONDALE RD
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-4105
Practice Address - Country:US
Practice Address - Phone:440-449-5682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5396103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling