Provider Demographics
NPI:1144216532
Name:BEDE, STEVEN T (LICSW)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:T
Last Name:BEDE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 FREMONT AVE N
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55411-1313
Mailing Address - Country:US
Mailing Address - Phone:612-287-9913
Mailing Address - Fax:612-287-9914
Practice Address - Street 1:2900 FREMONT AVE N
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55411-1313
Practice Address - Country:US
Practice Address - Phone:612-287-9913
Practice Address - Fax:612-287-9914
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12806104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1528392149OtherTRICARE
MN492493200Medicaid
MN9AA46SOOtherBLUE CROSS BLUE SHIELD BLUE PLUS
HP54883OtherHEALTH PARTNERS
CA1144216532OtherUBH