Provider Demographics
NPI:1982995239
Name:STANDIFORD, STEVEN A
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:A
Last Name:STANDIFORD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TRAVIS PL
Mailing Address - Street 2:
Mailing Address - City:HASTINGS ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10706-1706
Mailing Address - Country:US
Mailing Address - Phone:914-478-7801
Mailing Address - Fax:
Practice Address - Street 1:8 TRAVIS PL
Practice Address - Street 2:
Practice Address - City:HASTINGS ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10706-1706
Practice Address - Country:US
Practice Address - Phone:914-478-7801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR056560-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical