Provider Demographics
NPI:1538864624
Name:KISER, STEVIE (LCSW)
Entity type:Individual
Prefix:
First Name:STEVIE
Middle Name:
Last Name:KISER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 DESI LOOP
Mailing Address - Street 2:
Mailing Address - City:BELEN
Mailing Address - State:NM
Mailing Address - Zip Code:87002-8068
Mailing Address - Country:US
Mailing Address - Phone:575-835-4357
Mailing Address - Fax:
Practice Address - Street 1:614 BECKER AVE
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002-3634
Practice Address - Country:US
Practice Address - Phone:575-835-4357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-30
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical