Provider Demographics
NPI:1174872584
Name:STEVEN S. MINTER, PSY.D., LLC
Entity type:Organization
Organization Name:STEVEN S. MINTER, PSY.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:SHELBY
Authorized Official - Last Name:MINTER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:813-385-7041
Mailing Address - Street 1:607 S ALEXANDER ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-5053
Mailing Address - Country:US
Mailing Address - Phone:813-385-7041
Mailing Address - Fax:813-423-6568
Practice Address - Street 1:607 S ALEXANDER ST
Practice Address - Street 2:SUITE 104
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-5053
Practice Address - Country:US
Practice Address - Phone:813-385-7041
Practice Address - Fax:813-423-6568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8553261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health