Healthcare Provider Details

I. General information

NPI: 1992112270
Provider Name (Legal Business Name): STEPHANIE G FINE M.ED., PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2014
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 EVERGREEN CT TELEHEALTH ONLY
BLUE BELL PA
19422-2817
US

IV. Provider business mailing address

119 EVERGREEN CT
BLUE BELL PA
19422-2817
US

V. Phone/Fax

Practice location:
  • Phone: 484-324-8816
  • Fax:
Mailing address:
  • Phone: 215-680-8375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS017622
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: