Provider Demographics
NPI:1407907942
Name:STEELE, MALINDA ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MALINDA
Middle Name:ANN
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 1:9730 S WESTERN AVE
Mailing Address - Street 2:SUITE 627
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2814
Mailing Address - Country:US
Mailing Address - Phone:708-229-2976
Mailing Address - Fax:708-229-2977
Practice Address - Street 1:9730 S WESTERN AVE
Practice Address - Street 2:SUITE 627
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2814
Practice Address - Country:US
Practice Address - Phone:708-229-2976
Practice Address - Fax:708-229-2977
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490024811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1606183OtherBLUECROSSBLUESHIELD
1606183OtherBLUECROSSBLUESHIELD