Provider Demographics
NPI:1093709164
Name:STEEB, KELLY A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:A
Last Name:STEEB
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 1:4225 CUMING ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-1012
Mailing Address - Country:US
Mailing Address - Phone:402-594-4911
Mailing Address - Fax:402-885-8287
Practice Address - Street 1:4225 CUMING ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-1012
Practice Address - Country:US
Practice Address - Phone:402-594-4911
Practice Address - Fax:402-885-8287
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1006104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
85120OtherBCBS
P40029Medicare UPIN
85120OtherBCBS