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General NPI Number Information
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NPI Number | 1427171420
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Entity Type | Individual
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Provider Name | ROBERT THOMAS STEPHANS MSW, LMSW, ADS
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Gender | Male
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1313 LAKE DRIVE
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City | GRAND RAPIDS
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State | MI
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Zip | 49506
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Country | US
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Telephone | 616-459-7215
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Fax |
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Provider Business Mailing Address
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Address Line | 15835 GROESBECK ST
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City | GRAND HAVEN
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State | MI
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Zip | 49417-9173
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Country | US
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Telephone | 616-842-8051
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801077381
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License Number State | MI
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