Provider Demographics
NPI:1275570152
Name:STEELE, ANGELA J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:J
Last Name:STEELE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 N MULBERRY ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-1837
Mailing Address - Country:US
Mailing Address - Phone:270-765-2335
Mailing Address - Fax:270-765-2557
Practice Address - Street 1:312 N MULBERRY ST
Practice Address - Street 2:SUITE 1
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-1837
Practice Address - Country:US
Practice Address - Phone:270-765-2335
Practice Address - Fax:270-765-2557
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1487103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000228648OtherANTHEM
KY30605018Medicaid
KY30605018Medicaid
KY0974728Medicare PIN
KY00199015Medicare PIN
KY00206013Medicare PIN
KY0763555Medicare PIN
KY00201015Medicare PIN
KY00205013Medicare PIN
KY0762259Medicare PIN
LA00200015Medicare PIN
KY0762355Medicare PIN
KY00207013Medicare PIN