Provider Demographics
NPI:1215988175
Name:DIEHL, STEVEN K (PHD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:K
Last Name:DIEHL
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 1:39 TOLEDO AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4727
Mailing Address - Country:US
Mailing Address - Phone:401-440-7927
Mailing Address - Fax:401-842-0360
Practice Address - Street 1:850 AQUIDNECK AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-7244
Practice Address - Country:US
Practice Address - Phone:401-440-7927
Practice Address - Fax:401-842-0360
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPS00851103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI412175OtherBCHIP
RI411814OtherMEDICARE GROUP NUMBER
RISD32151OtherHARVARD PILGRIM
RI291415OtherBCBS
RI10301100OtherNHP
RISD32151Medicaid
RISD32151Medicaid
RISD32151OtherHARVARD PILGRIM
RI291415OtherBCBS