Provider Demographics
NPI:1568285450
Name:BOBB, STEVEN (MA, CAS)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:BOBB
Suffix:
Gender:M
Credentials:MA, CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S CAROLINE ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-1703
Mailing Address - Country:US
Mailing Address - Phone:410-513-9028
Mailing Address - Fax:
Practice Address - Street 1:100 S CAROLINE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-1703
Practice Address - Country:US
Practice Address - Phone:410-513-9028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool