Provider Demographics
NPI:1457331605
Name:EDWARDS, STEVEN DANIEL (LCSW)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:DANIEL
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4008
Mailing Address - Country:US
Mailing Address - Phone:406-327-1918
Mailing Address - Fax:406-549-2246
Practice Address - Street 1:900 N ORANGE ST STE 102
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-2951
Practice Address - Country:US
Practice Address - Phone:406-327-3034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5344281-35011041C0700X
MT9451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT107036117101OtherINTRMTN. HEALTH CARE
UT898697OtherDESERET MUTUAL
UT942938348WADOtherEDUCATORS MUTUAL
UT942938348WADOtherEDUCATORS MUTUAL