Provider Demographics
NPI:1376769513
Name:CLAIBORNE, STEVEN MICHAEL (BSW, LPN)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:CLAIBORNE
Suffix:
Gender:M
Credentials:BSW, LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 MANILA AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38114-1754
Mailing Address - Country:US
Mailing Address - Phone:901-726-6190
Mailing Address - Fax:
Practice Address - Street 1:427 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38126-2023
Practice Address - Country:US
Practice Address - Phone:901-577-0200
Practice Address - Fax:901-577-0207
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TNLPN39171164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered164W00000XNursing Service ProvidersLicensed Practical Nurse