Provider Demographics
NPI:1972533958
Name:FIRKINS, STEVEN J (MS, LCSW,CSAC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:FIRKINS
Suffix:
Gender:M
Credentials:MS, LCSW,CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:BLACK RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54615-9201
Mailing Address - Country:US
Mailing Address - Phone:715-284-4058
Mailing Address - Fax:
Practice Address - Street 1:703 ROSE ST
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-9201
Practice Address - Country:US
Practice Address - Phone:715-284-4058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2904123101YM0800X
WI1306-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI2904-123OtherCLINICAL SOCIAL WORKER
WI1306-132OtherCLINICAL SUBSTANCE ABUSE
WI39264100Medicaid