Provider Demographics
NPI:1861461907
Name:STEELE, DONALD WILLIAM (PHD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:WILLIAM
Last Name:STEELE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 407
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-0407
Mailing Address - Country:US
Mailing Address - Phone:508-947-1755
Mailing Address - Fax:508-946-6252
Practice Address - Street 1:339 CENTER ST
Practice Address - Street 2:#32
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-2143
Practice Address - Country:US
Practice Address - Phone:508-947-1755
Practice Address - Fax:508-946-6252
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2540103TC0700X, 103G00000X, 103TA0700X, 103TC1900X, 103TF0200X, 103TH0100X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0512656Medicaid
MAW03321Medicare ID - Type Unspecified