Provider Demographics
NPI:1902417512
Name:STIEVER, KAYLEN VICTORIA (LICSW, MSW)
Entity Type:Individual
Prefix:
First Name:KAYLEN
Middle Name:VICTORIA
Last Name:STIEVER
Suffix:
Gender:F
Credentials:LICSW, MSW
Other - Prefix:
Other - First Name:KAYLEN
Other - Middle Name:VICTORIA
Other - Last Name:KNUTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1951
Mailing Address - Country:US
Mailing Address - Phone:218-786-8364
Mailing Address - Fax:
Practice Address - Street 1:1522 E SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55812-1634
Practice Address - Country:US
Practice Address - Phone:218-391-3215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN292231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical