Provider Demographics
NPI:1659421600
Name:NELSON-STEFL, INGRID M (MSW, LMSW)
Entity Type:Individual
Prefix:MRS
First Name:INGRID
Middle Name:M
Last Name:NELSON-STEFL
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28404 QUAIL HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-2751
Mailing Address - Country:US
Mailing Address - Phone:248-553-0995
Mailing Address - Fax:
Practice Address - Street 1:17940 FARMINGTON RD STE 302
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3159
Practice Address - Country:US
Practice Address - Phone:248-421-1996
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801018543104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker