Stephen John Antonello in Mendota Heights - Clinical
Stephen John Antonello - NPI 1760548366
Stephen John Antonello is a Clinical in Mendota Heights, Minnesota. Stephen John Antonello practices all healthcare services and medical treatments related to Clinical. The NPI Number for Stephen John Antonello is 1760548366. The last update date is 2017-01-30.
Stephen John Antonello's current location address is 825 Deer Trail Pt, Mendota Heights, Minnesota. You can contact this provider via phone number 6516882335 and fax number 6516882669. The mailing address for Stephen John Antonello is 825 Deer Trail Pt, Mendota Heights, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stephen John Antonello |
|---|---|
| Address | 825 Deer Trail Pt, Mendota Heights, Minnesota |
| Phone Number | 6516882335 |
| Fax Number | 6516882669 |
| Sole Proprietor | Y |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1760548366 |
|---|---|
| Provider Enumeration Date | 2006-12-28 |
| Last Updated Date | 2017-01-30 |
Provider Mailing Address Detail
| Address | 825 Deer Trail Pt |
|---|---|
| City | Mendota Heights |
| State | Minnesota (MN) |
| Post Code | 551182750 |
| Phone Number | 6516882335 |
| Fax Number | 6516882669 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | LP1390 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 103667 | MN | UCARE | |
| 148547400 | MN | -- | |
| P00393789 | RAILROAD MEDICARE INDIV# | ||
| 6119337 | MEDICA | ||
| OE222AN | MN | BC BS INDIVIDUAL ID | |
| HP40542 | MN | HEALTH PARTNERS INDIVIDUA |
Post Comment/ Review Below
What is the Stephen John Antonello's unique identification number?
The Stephen John Antonello has been assigned the NPI (National Provider Identifier) Number 1760548366 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you share the physical location details of Stephen John Antonello?
The Stephen John Antonello is situated at 825 Deer Trail Pt, in the city of Mendota Heights, state of MN, with the zip code 551182750.
What is Stephen John Antonello's area of expertise and its corresponding taxonomy classification?
The Stephen John Antonello's field of specialization is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their areas of practice.
When was the Stephen John Antonello's 1760548366 issued?
The Stephen John Antonello's 1760548366 was issued on 2006-12-28.
As of what date were the details related to Stephen John Antonello most recently updated or revised?
The information pertaining to Stephen John Antonello, including its address, specialty, and other relevant details, was last updated or revised on 2017-01-30.
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