Provider Demographics
NPI:1316957830
Name:CHIOVOLONI, STEPHEN D (DSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:D
Last Name:CHIOVOLONI
Suffix:
Gender:M
Credentials:DSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 S 46TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-3129
Mailing Address - Country:US
Mailing Address - Phone:479-494-7889
Mailing Address - Fax:479-494-7890
Practice Address - Street 1:1620 S 46TH ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-3129
Practice Address - Country:US
Practice Address - Phone:479-494-7000
Practice Address - Fax:479-494-7890
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2295C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty