Provider Demographics
NPI:1427169499
Name:KANTER, STEVEN H (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:H
Last Name:KANTER
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 1:934 SOM CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3537
Mailing Address - Country:US
Mailing Address - Phone:440-461-1586
Mailing Address - Fax:
Practice Address - Street 1:15 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-3125
Practice Address - Country:US
Practice Address - Phone:440-428-3010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4006103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0821025Medicaid
OH0821025Medicaid