Basic Information
| Provider Information | |||||||||
| NPI: | 1720261555 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JON J STEIMEL, ACSW, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 10 | ||||||||
| Address2: | |||||||||
| City: | MASON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488540010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5176769788 | ||||||||
| FaxNumber: | 5176763438 | ||||||||
| Practice Location | |||||||||
| Address1: | 116 W SUPERIOR ST | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | ALMA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488011650 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9899684017 | ||||||||
| FaxNumber: | 7076764621 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2007 | ||||||||
| LastUpdateDate: | 06/08/2009 | ||||||||
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| AuthorizedOfficialLastName: | STEIMEL | ||||||||
| AuthorizedOfficialFirstName: | JON | ||||||||
| AuthorizedOfficialMiddleName: | JAY | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CLINICIAN | ||||||||
| AuthorizedOfficialTelephone: | 9899684017 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 6801012357 | MI | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 1013948884 | 01 | MI | NPPES-PERSONAL NPI NUMBER | OTHER |