Provider Demographics
NPI:1528268539
Name:HUEBSCHWERLEN, STEPHEN (LICSW)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:HUEBSCHWERLEN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S 2ND ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58504-5729
Mailing Address - Country:US
Mailing Address - Phone:701-751-1549
Mailing Address - Fax:701-751-1549
Practice Address - Street 1:600 S 2ND ST
Practice Address - Street 2:SUITE 215
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58504-5729
Practice Address - Country:US
Practice Address - Phone:701-751-1549
Practice Address - Fax:701-751-1549
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND200OtherLICENSE
ND1454796Medicaid
ND200OtherLICENSE
ND19188Medicaid