Provider Demographics
NPI:1528165586
Name:STEELE, TERESA J (LCSW)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:J
Last Name:STEELE
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 1:566 SALEMVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW ENTERPRISE
Mailing Address - State:PA
Mailing Address - Zip Code:16664-8141
Mailing Address - Country:US
Mailing Address - Phone:814-243-6359
Mailing Address - Fax:
Practice Address - Street 1:110 W MAIN ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537-1131
Practice Address - Country:US
Practice Address - Phone:814-652-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0149651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1014775240002Medicaid
PA1014775240002Medicaid