Provider Demographics
NPI:1841741436
Name:STEELE, JOHN (MA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:STEELE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5135 ROEDEL RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:MI
Mailing Address - Zip Code:48722-9735
Mailing Address - Country:US
Mailing Address - Phone:989-295-2530
Mailing Address - Fax:
Practice Address - Street 1:5135 ROEDEL RD
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:MI
Practice Address - Zip Code:48722-9735
Practice Address - Country:US
Practice Address - Phone:989-295-2530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016845103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist