Provider Demographics
NPI:1811023096
Name:CLEVELAND, STEPHEN (LCSW)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:CLEVELAND
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 N 925 E
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:IN
Mailing Address - Zip Code:46365-9741
Mailing Address - Country:US
Mailing Address - Phone:574-298-5325
Mailing Address - Fax:
Practice Address - Street 1:2809 N 925 E
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:IN
Practice Address - Zip Code:46365-9741
Practice Address - Country:US
Practice Address - Phone:574-298-5325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2011-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004984A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical