Basic Information
| Provider Information | |||||||||
| NPI: | 1639178965 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEEP | ||||||||
| FirstName: | ANGELA | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | PSYD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 374 W RIDGE DR | ||||||||
| Address2: | |||||||||
| City: | MURPHY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 289068639 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8288372502 | ||||||||
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| Practice Location | |||||||||
| Address1: | 330 VALLEY RIVER AVE | ||||||||
| Address2: | |||||||||
| City: | MURPHY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 289062923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8288370071 | ||||||||
| FaxNumber: | 8667623954 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TA0700X | PY7053 | FL | X | Behavioral Health & Social Service Providers | Psychologist | Adult Development & Aging | 103TC0700X | P2649 | TN | X | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 3982202 | 05 | TN | MEDICAID |