Provider Demographics
NPI:1508457268
Name:STELT, DEANNA MARIE (MA LSW)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:MARIE
Last Name:STELT
Suffix:
Gender:F
Credentials:MA LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 SALT SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44481-9231
Mailing Address - Country:US
Mailing Address - Phone:330-502-7163
Mailing Address - Fax:
Practice Address - Street 1:725 BOARDMAN CANFIELD RD STE L1
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-4370
Practice Address - Country:US
Practice Address - Phone:330-330-8655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.00141231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical