MEDICARE: MR. STEPHEN PHILIPSON LCSW

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	1041C0700X	Clinical Social Worker	PRO170851	NY
2	106H00000X	Marriage & Family Therapist	PRO170851	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G87809	OTHER		VBH
2	0028559	OTHER		GHI

General Provider Information

NPI Number	:	1174689202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN PHILIPSON LCSW

Provider Business Mailing Address
First Line	:	497 4TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-3006
Country	:	US
Telephone Number	:	718-499-7284
Fax Number	:

Provider Business Practice Location Address
First Line	:	497 4TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-3006
Country	:	US
Telephone Number	:	718-499-7284
Fax Number	:	718-499-7284

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

Provider Enumeration Date	:	01/01/2007
Last Update Date	:	09/11/2025

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