Provider Demographics
NPI:1003009572
Name:STOVER-CONWELL, RITA JOAN (MSW)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:JOAN
Last Name:STOVER-CONWELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 VASBINDER DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46017-1032
Mailing Address - Country:US
Mailing Address - Phone:765-378-6310
Mailing Address - Fax:
Practice Address - Street 1:925 VASBINDER DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:IN
Practice Address - Zip Code:46017-1032
Practice Address - Country:US
Practice Address - Phone:765-378-6310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-19
Last Update Date:2007-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003989A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical