Provider Demographics
NPI:1538228085
Name:MCDONNELL, STEPHEN (LCSW)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:MCDONNELL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 7TH AVE STE 710
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-2002
Mailing Address - Country:US
Mailing Address - Phone:347-304-1060
Mailing Address - Fax:347-382-9422
Practice Address - Street 1:421 7TH AVE STE 710
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-2002
Practice Address - Country:US
Practice Address - Phone:347-304-1060
Practice Address - Fax:347-382-9422
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0772561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical