Provider Demographics
NPI:1053428896
Name:WHEELER, STEVEN G (LMSW, LPC)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:G
Last Name:WHEELER
Suffix:
Gender:M
Credentials:LMSW, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:HERSEY
Mailing Address - State:MI
Mailing Address - Zip Code:49639-0124
Mailing Address - Country:US
Mailing Address - Phone:231-679-4372
Mailing Address - Fax:231-468-2596
Practice Address - Street 1:2721 SUNNYSIDE DR
Practice Address - Street 2:SUITE B
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601-8748
Practice Address - Country:US
Practice Address - Phone:231-468-2550
Practice Address - Fax:231-468-2596
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2011-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401002628101YP2500X
MI68010600671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical