Provider Demographics
NPI:1023482403
Name:STEFAN C. BEAN, PC
Entity type:Organization
Organization Name:STEFAN C. BEAN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:STEFAN
Authorized Official - Middle Name:CARTER
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:406-253-0711
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903-0532
Mailing Address - Country:US
Mailing Address - Phone:406-253-0711
Mailing Address - Fax:
Practice Address - Street 1:40 2ND ST E
Practice Address - Street 2:SUITE 212
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-6110
Practice Address - Country:US
Practice Address - Phone:406-253-0711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-22
Last Update Date:2015-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty