MEDICARE: HOLLY STEADMAN

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1144594870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOLLY STEADMAN

Provider Business Mailing Address
First Line	:	80 WEST ST
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-6531
Country	:	US
Telephone Number	:	203-748-5689
Fax Number	:	203-205-2757

Provider Business Practice Location Address
First Line	:	80 WEST ST
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06810-6531
Country	:	US
Telephone Number	:	203-748-5689
Fax Number	:	203-205-2757

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

Provider Enumeration Date	:	02/27/2012
Last Update Date	:	02/27/2012

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Directions to “ HOLLY STEADMAN ” Practice Location

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