Provider Demographics
NPI:1184906588
Name:ELLER, STEVEN B (LPC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:B
Last Name:ELLER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CHESTNUT ST
Mailing Address - Street 2:STE.1001
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-1453
Mailing Address - Country:US
Mailing Address - Phone:325-437-1001
Mailing Address - Fax:325-437-1005
Practice Address - Street 1:500 CHESTNUT ST
Practice Address - Street 2:STE.1001
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-1453
Practice Address - Country:US
Practice Address - Phone:325-437-1001
Practice Address - Fax:325-437-1005
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64845101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX303933101Medicaid