Provider Demographics
NPI:1598192577
Name:STEELE, KIM (LPCC-S,LICDC-CS,LSW)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:STEELE
Suffix:
Gender:F
Credentials:LPCC-S,LICDC-CS,LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTONVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44490-9740
Mailing Address - Country:US
Mailing Address - Phone:330-853-8149
Mailing Address - Fax:
Practice Address - Street 1:45875 BELL SCHOOL RD STE B
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-8728
Practice Address - Country:US
Practice Address - Phone:330-397-6007
Practice Address - Fax:234-254-5655
Is Sole Proprietor?:No
Enumeration Date:2013-10-04
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.00171311041C0700X
OHE.0500707 SUPV101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH411793Medicaid