Healthcare Provider Details

I. General information

NPI: 1245156223
Provider Name (Legal Business Name): STEPHEN GREENFIELD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1519 MERCHANT ST
EMPORIA KS
66801-5005
US

IV. Provider business mailing address

1519 MERCHANT ST
EMPORIA KS
66801-5005
US

V. Phone/Fax

Practice location:
  • Phone: 620-343-2211
  • Fax: 620-342-1021
Mailing address:
  • Phone: 620-343-2211
  • Fax: 620-342-1021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number03560
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: