Provider Demographics
NPI:1740744499
Name:STEELE-RENDON, SANDRA MABEL (LCSW MENTAL HEALTH)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:MABEL
Last Name:STEELE-RENDON
Suffix:
Gender:F
Credentials:LCSW MENTAL HEALTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5069 LINDENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-1728
Mailing Address - Country:US
Mailing Address - Phone:314-704-2026
Mailing Address - Fax:
Practice Address - Street 1:1027 BELLEVUE AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1851
Practice Address - Country:US
Practice Address - Phone:314-768-8056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170346371041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical