Provider Demographics
NPI:1952079519
Name:VAN STEENIS, MILISA JUNE (CDCA II)
Entity Type:Individual
Prefix:MS
First Name:MILISA
Middle Name:JUNE
Last Name:VAN STEENIS
Suffix:
Gender:F
Credentials:CDCA II
Other - Prefix:MS
Other - First Name:MILISA
Other - Middle Name:JUNE
Other - Last Name:VAN STEENIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CDCA E
Mailing Address - Street 1:326 S WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-3058
Mailing Address - Country:US
Mailing Address - Phone:614-374-2215
Mailing Address - Fax:
Practice Address - Street 1:326 S WARREN AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-3058
Practice Address - Country:US
Practice Address - Phone:614-374-2215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.176482101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)