Provider Demographics
NPI:1124278049
Name:CHASTEEN, STEPHEN PAUL (LISW-CP, LCSW)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:PAUL
Last Name:CHASTEEN
Suffix:
Gender:M
Credentials:LISW-CP, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 KINGSMOOR DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-3502
Mailing Address - Country:US
Mailing Address - Phone:843-817-9008
Mailing Address - Fax:
Practice Address - Street 1:958 E MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29302-2148
Practice Address - Country:US
Practice Address - Phone:864-641-6632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-28
Last Update Date:2016-07-21
Deactivation Date:2010-11-19
Deactivation Code:
Reactivation Date:2011-11-08
Provider Licenses
StateLicense IDTaxonomies
NCC0083261041C0700X
SC69261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical