| Doctor Name: | ELLEN J STEVENS |
| NPI Number: | 1982638409 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 2352 |
| Business Practice Address: | 2900 Doolittle Dr Ellsworth Afb, SD - 577064821 |
| Business Phone Number: | 6059236573 |
| Business Fax Number: | 6053852030 |
| Mailing Address: | 1430 Haines Ave, Suite 108 RAPID CITY |
| State: | SD |
| Postal Code: | 577010689 |
| Phone Number: | 6059236573 |
| Fax Number: | 6053852030 |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 01/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 2352 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |