Basic Information
Provider Information
NPI: 1629126917
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STERMAN
FirstName: ILANA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1025 CONNECTICUT AVE NW STE 1000
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200365417
CountryCode: US
TelephoneNumber: 2023092048
FaxNumber:  
Practice Location
Address1: 1025 CONNECTICUT AVE NW STE 1000
Address2:  
City: WASHINGTON
State: DC
PostalCode: 200365512
CountryCode: US
TelephoneNumber: 2023092048
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/05/2007
LastUpdateDate: 02/16/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XLC1697MDN Behavioral Health & Social Service ProvidersCounselorMental Health
103T00000XPSY1001335DCN Behavioral Health & Social Service ProvidersPsychologist 
103T00000X0810005660VAN Behavioral Health & Social Service ProvidersPsychologist 
101YM0800XPRC13801DCY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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