MEDICARE: STEVEN DANIEL EDWARDS L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	5344281-3501	UT
2	1041C0700X	Clinical Social Worker	945	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	107036117101	OTHER	UT	INTRMTN. HEALTH CARE
2	898697	OTHER	UT	DESERET MUTUAL
3	942938348WAD	OTHER	UT	EDUCATORS MUTUAL

General Provider Information

NPI Number	:	1457331605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN DANIEL EDWARDS L.C.S.W.

Provider Business Mailing Address
First Line	:	500 W BROADWAY ST
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-4008
Country	:	US
Telephone Number	:	406-327-1918
Fax Number	:	406-549-2246

Provider Business Practice Location Address
First Line	:	900 N ORANGE ST STE 102
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-2951
Country	:	US
Telephone Number	:	406-327-3034
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2006
Last Update Date	:	10/21/2021

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Directions to “ STEVEN DANIEL EDWARDS L.C.S.W.” Practice Location

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