Organization
STEPHEN E NASSAR PSY D LCSW P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN EDWARD NASSAR PSYD, LCSW (CEO)
(321) 751-3636
Entity
Organization
Contact information
Practice address
3684 N WICKHAM RD, SUITE B, MELBOURNE, FL 32935-2328
(321) 751-3636
(321) 751-8108
Mailing address
3684 N WICKHAM RD, SUITE B, MELBOURNE, FL 32935-2328
(321) 751-3636
(321) 751-8108
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY6228
FL
1041C0700X
Clinical Social Worker
SW3802
FL
Other
Enumeration date
07/10/2006
Last updated
10/26/2011
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