Provider Demographics
NPI:1427663905
Name:ESTEP, JOHN DAVID (LICSW)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:ESTEP
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4801 VETERANS DR
Mailing Address - Street 2:B28 RM 155
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2099
Mailing Address - Country:US
Mailing Address - Phone:320-293-0631
Mailing Address - Fax:320-264-7695
Practice Address - Street 1:4801 VETERANS DR
Practice Address - Street 2:B28 RM 155
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-2099
Practice Address - Country:US
Practice Address - Phone:320-293-0631
Practice Address - Fax:320-264-7695
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN273351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical