Provider Demographics
NPI:1770855074
Name:STEELE, KELLI JO (CMHC)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:JO
Last Name:STEELE
Suffix:
Gender:F
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:283 N 300 W STE 501
Mailing Address - Street 2:
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037-1881
Mailing Address - Country:US
Mailing Address - Phone:801-882-7030
Mailing Address - Fax:
Practice Address - Street 1:283 N 300 W STE 501
Practice Address - Street 2:
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037-1881
Practice Address - Country:US
Practice Address - Phone:801-882-7030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
UT8577162-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health