Provider Demographics
NPI:1518999846
Name:STEELE, KATHERINE L (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:L
Last Name:STEELE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:L
Other - Last Name:STEELE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:54174 JUDAY LAKE DR W
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1755
Mailing Address - Country:US
Mailing Address - Phone:574-703-1551
Mailing Address - Fax:574-318-8869
Practice Address - Street 1:222 S FRANCES ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-3004
Practice Address - Country:US
Practice Address - Phone:574-703-1551
Practice Address - Fax:574-318-8869
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20040894103TC1900X
IN20040894A103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200161280 AMedicaid