MEDICARE: MARY STEELE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	194205	OH

General Provider Information

NPI Number	:	1073477311
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY STEELE

Provider Business Mailing Address
First Line	:	1159 COUNTY ROAD 411
Second Line	:
City	:	PROCTORVILLE
State	:	OH
Zip	:	45669-9409
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1159 COUNTY ROAD 411
Second Line	:
City	:	PROCTORVILLE
State	:	OH
Zip	:	45669-9409
Country	:	US
Telephone Number	:	423-973-1614
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2025
Last Update Date	:	12/11/2025

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Directions to “ MARY STEELE ” Practice Location

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