Basic Information
| Provider Information | |||||||||
| NPI: | 1588024343 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEELE | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.S. LPCC-S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 825 N MAIN ST STE 140 | ||||||||
| Address2: | |||||||||
| City: | SPRINGBORO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450662100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9377625000 | ||||||||
| FaxNumber: | 9377625014 | ||||||||
| Practice Location | |||||||||
| Address1: | 825 N MAIN ST STE 140 | ||||||||
| Address2: | |||||||||
| City: | SPRINGBORO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45066 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9377625000 | ||||||||
| FaxNumber: | 9377625009 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2016 | ||||||||
| LastUpdateDate: | 02/15/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 1300271 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 0174629 | 05 | OH | MEDICAID |