Healthcare Provider Details

I. General information

NPI: 1710028774
Provider Name (Legal Business Name): MYRON BUD STERN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 PUBLIC SQ TERMINAL TOWER, STE. 852
CLEVELAND OH
44113-2208
US

IV. Provider business mailing address

50 PUBLIC SQ TERMINAL TOWER, STE. 852
CLEVELAND OH
44113-2208
US

V. Phone/Fax

Practice location:
  • Phone: 216-579-0560
  • Fax: 216-579-0544
Mailing address:
  • Phone: 216-579-0560
  • Fax: 216-579-0544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number339
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number339
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: