Basic Information
Provider Information
NPI: 1639321243
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OSTER
FirstName: STEVEN
MiddleName: L.
NamePrefix: MR.
NameSuffix:  
Credential: MA, MFT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3435 W CRAIG RD
Address2: SUITE A
City: NORTH LAS VEGAS
State: NV
PostalCode: 890325115
CountryCode: US
TelephoneNumber: 7027500377
FaxNumber: 7025387928
Practice Location
Address1: 3435 W CRAIG RD
Address2: SUITE A
City: NORTH LAS VEGAS
State: NV
PostalCode: 890325115
CountryCode: US
TelephoneNumber: 7027500377
FaxNumber: 7025387928
Other Information
ProviderEnumerationDate: 10/14/2008
LastUpdateDate: 10/14/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
106H00000X0732NVY Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


Home