Provider Demographics
NPI:1245707280
Name:GILPIN, STEVEN LOGAN (LMSW)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:LOGAN
Last Name:GILPIN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 W STADIUM BLVD UNIT 1671
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48106-7725
Mailing Address - Country:US
Mailing Address - Phone:734-224-3544
Mailing Address - Fax:
Practice Address - Street 1:1500 GREENVIEW DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-5704
Practice Address - Country:US
Practice Address - Phone:734-244-3544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-29
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011021971041C0700X
MI68011065331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical