Provider Demographics
NPI:1891857249
Name:STEELE, WENDY LEVITT (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:LEVITT
Last Name:STEELE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Mailing Address - Street 1:106 SHOPPERS WAY STE 115
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-0522
Mailing Address - Country:US
Mailing Address - Phone:912-265-7660
Mailing Address - Fax:912-265-7858
Practice Address - Street 1:1712 OSBORNE RD
Practice Address - Street 2:STE A
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-9103
Practice Address - Country:US
Practice Address - Phone:912-882-5515
Practice Address - Fax:912-265-7858
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2018-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0012801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00975279CMedicaid
GA80BBFQVMedicare ID - Type UnspecifiedMEDICARE