Provider Demographics
NPI:1588336598
Name:EHLERS, STEVEN WILLIAM (RBT)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:WILLIAM
Last Name:EHLERS
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 LESLIE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-1448
Mailing Address - Country:US
Mailing Address - Phone:347-857-5004
Mailing Address - Fax:
Practice Address - Street 1:460 MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-5104
Practice Address - Country:US
Practice Address - Phone:718-667-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRBT-18-57613103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst