Healthcare Provider Details

I. General information

NPI: 1982109393
Provider Name (Legal Business Name): STEPHEN LAWRENCE HAMBURGER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10301 HAGEN RANCH RD STE B200
BOYNTON BEACH FL
33437-3723
US

IV. Provider business mailing address

1065 NE 125TH ST STE 300
NORTH MIAMI FL
33161-5833
US

V. Phone/Fax

Practice location:
  • Phone: 561-752-9490
  • Fax: 561-752-9491
Mailing address:
  • Phone: 888-852-6672
  • Fax: 305-891-4228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9935
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9935
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: