Provider Demographics
NPI:1629859657
Name:STEELE, SHANNON LA'SHAE (LMSW-MPH)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:LA'SHAE
Last Name:STEELE
Suffix:
Gender:F
Credentials:LMSW-MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1127 FREEDOM PKWY
Mailing Address - Street 2:
Mailing Address - City:MONTEVALLO
Mailing Address - State:AL
Mailing Address - Zip Code:35115-8653
Mailing Address - Country:US
Mailing Address - Phone:256-466-6450
Mailing Address - Fax:
Practice Address - Street 1:300 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2474
Practice Address - Country:US
Practice Address - Phone:205-538-3099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6125G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker