Provider Demographics
NPI:1407465263
Name:STEELE, RICHARD LAMAR (BA/CDCA PRELIMINARY)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LAMAR
Last Name:STEELE
Suffix:
Gender:M
Credentials:BA/CDCA PRELIMINARY
Other - Prefix:
Other - First Name:RICHARD
Other - Middle Name:LAMAR
Other - Last Name:STEELE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RICHARD STEELE
Mailing Address - Street 1:5460 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-4005
Mailing Address - Country:US
Mailing Address - Phone:614-426-7403
Mailing Address - Fax:
Practice Address - Street 1:5460 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-4005
Practice Address - Country:US
Practice Address - Phone:614-426-7403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH174141101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)