Provider Demographics
NPI:1104987239
Name:KAGEL, STEVEN A (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:KAGEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:SUFFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06078-2084
Mailing Address - Country:US
Mailing Address - Phone:860-668-4342
Mailing Address - Fax:
Practice Address - Street 1:133 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:SUFFIELD
Practice Address - State:CT
Practice Address - Zip Code:06078-2084
Practice Address - Country:US
Practice Address - Phone:860-668-4342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1250103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
C0009465OtherCHAMPUS
133784OtherVALUE OPTIONS
184361OtherMANAGED HEALTH NETWORK
48047OtherCIGNA BEHABIORAL HEALTH
CT0600001250CT01OtherANTHEM BLUE CROSS BLUE SH
HAS230OtherOXFORD HEALTH PLANS
CT620000268Medicare ID - Type Unspecified