Individual
DR. MICHAEL STEFANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
302 9TH ST, HONESDALE, PA 18431-2090
(570) 253-6453
(570) 253-5856
Mailing address
302 9TH ST, HONESDALE, PA 18431-2090
(570) 253-6453
(570) 253-5856
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PS016606
PA
103TB0200X
Cognitive & Behavioral Psychologist
PS016606
PA
103TC0700X
Clinical Psychologist
Primary
PS016606
PA
103TC2200X
Clinical Child & Adolescent Psychologist
PS016606
PA
103TF0000X
Family Psychologist
PS016606
PA
103TF0200X
Forensic Psychologist
PS016606
PA
103TH0004X
Health Psychologist
PS016606
PA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PS016606
PA
103TP2701X
Group Psychotherapy Psychologist
PS016606
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS016606
—
PA
Enumeration date
07/02/2007
Last updated
02/27/2019
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