Provider Demographics
NPI:1518382001
Name:STEFFES, MALISSA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:MALISSA
Middle Name:
Last Name:STEFFES
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3212 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-3814
Mailing Address - Country:US
Mailing Address - Phone:406-850-2458
Mailing Address - Fax:
Practice Address - Street 1:3212 1ST AVE S
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-3814
Practice Address - Country:US
Practice Address - Phone:406-850-2458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT46941041C0700X
MTSWP-LCSW-LIC-4694251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT81-0262019OtherEIN