Provider Demographics
NPI:1386269694
Name:STEFFES, JASON ALLEN (LLBSW)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:ALLEN
Last Name:STEFFES
Suffix:
Gender:M
Credentials:LLBSW
Other - Prefix:
Other - First Name:JASON
Other - Middle Name:ALLEN
Other - Last Name:STEFFES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NREMT-P
Mailing Address - Street 1:201 MULHOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-7693
Mailing Address - Country:US
Mailing Address - Phone:989-895-2315
Mailing Address - Fax:
Practice Address - Street 1:201 MULHOLLAND ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-7693
Practice Address - Country:US
Practice Address - Phone:989-895-2315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802090818104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker