Provider Demographics
NPI:1972699650
Name:STEINKAMP, MATTHEW CHARLES (LICSW)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:CHARLES
Last Name:STEINKAMP
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 W SAINT GERMAIN
Mailing Address - Street 2:SUITE 580
Mailing Address - City:ST. CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301
Mailing Address - Country:US
Mailing Address - Phone:320-253-1909
Mailing Address - Fax:320-240-1501
Practice Address - Street 1:1010 W SAINT GERMAIN
Practice Address - Street 2:SUITE 580
Practice Address - City:ST. CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301
Practice Address - Country:US
Practice Address - Phone:320-253-1909
Practice Address - Fax:320-240-1501
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN94491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6243229OtherMEDICA
MN6243229Medicaid
MN48D61STOtherBCBS MINNESOTA
MN1028027OtherPREFERREDONE