Provider Demographics
NPI:1043316623
Name:STEIN, HELENE W (PH D)
Entity type:Individual
Prefix:DR
First Name:HELENE
Middle Name:W
Last Name:STEIN
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LINCOLN ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:NEWTON HIGHLANDS
Mailing Address - State:MA
Mailing Address - Zip Code:02461-1527
Mailing Address - Country:US
Mailing Address - Phone:617-630-9190
Mailing Address - Fax:617-965-4953
Practice Address - Street 1:30 LINCOLN ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEWTON HIGHLANDS
Practice Address - State:MA
Practice Address - Zip Code:02461-1527
Practice Address - Country:US
Practice Address - Phone:617-630-9190
Practice Address - Fax:617-965-4953
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4832103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAST WO4627Medicare ID - Type UnspecifiedMEDICARE PART B PROVIDER