Provider Demographics
NPI:1295876266
Name:STELLER, CHRISTOPHER J (LICSW)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:J
Last Name:STELLER
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 1:8737 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:VT
Mailing Address - Zip Code:05648-7511
Mailing Address - Country:US
Mailing Address - Phone:802-223-3867
Mailing Address - Fax:
Practice Address - Street 1:8737 COUNTY RD
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:VT
Practice Address - Zip Code:05648-7511
Practice Address - Country:US
Practice Address - Phone:802-223-3867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00006511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT61809OtherMVP PROVIDER NUMBER
VT1047412OtherCIGNA PROVIDER #
VT29987OtherBCBS PROVIDER NUMBER
VTOVN2208Medicaid