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Stephen E Illing, LAC
Addiction (Substance Use Disorder) Counselor in Fargo, North Dakota
NPI 1255348991

Stephen E Illing is an Addiction (Substance Use Disorder) Counselor based in Fargo, ND and is specialized in Addiction (Substance Use Disorder). Stephen E Illing practices in Fargo, ND and has the professional credentials of LAC. The NPI Number for Stephen E Illing is 1255348991 and holds a License No. 1059 (North Dakota).

The current practice location address for Stephen E Illing is 2624 9Th Ave S, Fargo, ND and can be reached out via phone at 701-298-4500 and via fax at 701-298-4400.

Location: 2624 9Th Ave S, Fargo, ND, 58103-2350
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Provider Profile Details
NPI Number
1255348991
Provider Name
Stephen E Illing
Credential
LAC
Provider Entity Type
Individual
Gender
Male
Address
2624 9Th Ave S, Fargo, ND, 58103-2350
Phone Number
701-298-4500
Fax Number
701-298-4400
Provider Enumeration Date
08/02/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
015105 01 ND BCBS OF ND PIN
institution
Provider Business Practice Location Address Details
Address
2624 9Th Ave S
City
State
Zip
58103-2350
Phone Number
701-298-4500
Fax Number
701-298-4400
person
Provider Business Mailing Address Details
Address
2624 9Th Ave S
City
State
Zip
58103-2350
Phone Number
701-298-4500
Fax Number
701-298-4400
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
1059 (North Dakota)
Definition
Definition to come...
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