Healthcare Provider Details

I. General information

NPI: 1750553988
Provider Name (Legal Business Name): STEVEN RICHARD BLAUNER L.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 E MAIN ST STE 301
MOUNT KISCO NY
10549-3036
US

IV. Provider business mailing address

580 WHITE PLAINS RD STE 510
TARRYTOWN NY
10591-5152
US

V. Phone/Fax

Practice location:
  • Phone: 914-666-4646
  • Fax:
Mailing address:
  • Phone: 914-345-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR047921
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: