Provider Demographics
NPI:1407957020
Name:LANSING, STEPHEN E (LICSW)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:E
Last Name:LANSING
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 1:602 11TH AVE NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1805
Mailing Address - Country:US
Mailing Address - Phone:507-292-1379
Mailing Address - Fax:507-289-4524
Practice Address - Street 1:602 11TH AVE NW
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-1805
Practice Address - Country:US
Practice Address - Phone:507-292-1379
Practice Address - Fax:507-289-4524
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN81201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical