Provider Demographics
NPI:1528333408
Name:STEINER, CARRIE LYNN (PSYD)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:STEINER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 E BUTTERFIELD RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5618
Mailing Address - Country:US
Mailing Address - Phone:630-909-9094
Mailing Address - Fax:630-597-2583
Practice Address - Street 1:477 E BUTTERFIELD RD
Practice Address - Street 2:SUITE 204
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5618
Practice Address - Country:US
Practice Address - Phone:630-909-9094
Practice Address - Fax:630-597-2583
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008311103TC0700X, 103TB0200X, 103TM1800X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
F300208691OtherMEDICARE PTAN