MEDICARE: DR. STEPHEN PAUL FINK PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	1006	WV
2	103T00000X	Psychologist	1006	WV
3	103T00000X	Psychologist	7111	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083917512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEPHEN PAUL FINK PSY.D.

Provider Business Mailing Address
First Line	:	5228 OLD SAINT MARYS PIKE
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26104-8557
Country	:	US
Telephone Number	:	304-464-5482
Fax Number	:

Provider Business Practice Location Address
First Line	:	5228 OLD SAINT MARYS PIKE
Second Line	:
City	:	PARKERSBURG
State	:	WV
Zip	:	26104-8557
Country	:	US
Telephone Number	:	304-464-5482
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2010
Last Update Date	:	04/09/2014

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