Healthcare Provider Details

I. General information

NPI: 1790936938
Provider Name (Legal Business Name): STEVEN M ESSIG PSYD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2008
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CLINT MOORE RD SUITE 120
BOCA RATON FL
33487-2768
US

IV. Provider business mailing address

107 CANTERSTONE CT
CARY NC
27518-2251
US

V. Phone/Fax

Practice location:
  • Phone: 561-732-7000
  • Fax: 561-731-2997
Mailing address:
  • Phone: 561-732-7000
  • Fax: 561-536-5753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY6865
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY6865
License Number StateFL

VIII. Authorized Official

Name: DR. STEVEN MICHAEL ESSIG
Title or Position: PRESIDENT
Credential: PSY.D.
Phone: 561-732-7000