Provider Demographics
NPI:1578180014
Name:STEELE, JUSTINE LAUREN (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:JUSTINE
Middle Name:LAUREN
Last Name:STEELE
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6073 WATERLOO RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-1914
Mailing Address - Country:US
Mailing Address - Phone:937-367-2913
Mailing Address - Fax:
Practice Address - Street 1:3876 INDIAN RIPPLE RD STE A
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45440-3448
Practice Address - Country:US
Practice Address - Phone:937-230-1058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1501011104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker