Healthcare Provider Details

I. General information

NPI: 1235528563
Provider Name (Legal Business Name): STEPS PSYCHOLOGICAL PRACTICE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2015
Last Update Date: 01/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11835 QUEENS BLVD
FOREST HILLS NY
11375-7200
US

IV. Provider business mailing address

PO BOX 750834
FOREST HILLS NY
11375-0834
US

V. Phone/Fax

Practice location:
  • Phone: 718-268-6600
  • Fax: 718-268-6065
Mailing address:
  • Phone: 718-268-6600
  • Fax: 718-268-6065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. SUSAN A STEPAKOFF
Title or Position: OWNER
Credential: PHD
Phone: 718-268-6600