Provider Demographics
NPI:1518437938
Name:ESTEP, KRISTEN ANNE (LSW)
Entity Type:Individual
Prefix:MISS
First Name:KRISTEN
Middle Name:ANNE
Last Name:ESTEP
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:994 VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-2948
Mailing Address - Country:US
Mailing Address - Phone:440-242-9990
Mailing Address - Fax:
Practice Address - Street 1:1865 N RIDGE RD E STE E
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3360
Practice Address - Country:US
Practice Address - Phone:440-723-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
S.0909225104100000X
OHS.0909225104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker