Healthcare Provider Details

I. General information

NPI: 1750458030
Provider Name (Legal Business Name): JEFFREY D STEIN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 ANDOVER ST STE 302
DANVERS MA
01923-1443
US

IV. Provider business mailing address

175 ANDOVER ST STE 302
DANVERS MA
01923-1443
US

V. Phone/Fax

Practice location:
  • Phone: 978-740-3100
  • Fax:
Mailing address:
  • Phone: 978-740-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number8048
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: