MEDICARE: MR. STEPHEN CHARLES STRANG M.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	34001826A	IN

General Provider Information

NPI Number	:	1770553935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN CHARLES STRANG M.S.W.

Provider Business Mailing Address
First Line	:	1222 S 25TH ST
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46615-1714
Country	:	US
Telephone Number	:	574-273-6680
Fax Number	:	574-273-6681

Provider Business Practice Location Address
First Line	:	1222 S 25TH ST
Second Line	:
City	:	SOUTH BEND
State	:	IN
Zip	:	46615-1714
Country	:	US
Telephone Number	:	574-273-6680
Fax Number	:	574-273-6681

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	12/03/2016

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