Provider Demographics
NPI:1992556872
Name:GIDDENS, STEVEN RYAN (LPC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:RYAN
Last Name:GIDDENS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 23RD AVE N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-1923
Mailing Address - Country:US
Mailing Address - Phone:701-730-7657
Mailing Address - Fax:
Practice Address - Street 1:306 23RD AVE N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-1923
Practice Address - Country:US
Practice Address - Phone:701-730-7657
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1173-1-1-22101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health