Healthcare Provider Details

I. General information

NPI: 1427784552
Provider Name (Legal Business Name): LISA M DEJORDY STEELE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LISA STEELE LCSW, CSAT, CPTT

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 E INDIAN SCHOOL RD
PHOENIX AZ
85012-1839
US

IV. Provider business mailing address

19801 N 59TH AVE # 11562 19801 N 59TH AVE # 11562
GLENDALE AZ
85318-1413
US

V. Phone/Fax

Practice location:
  • Phone: 602-277-5551
  • Fax:
Mailing address:
  • Phone: 623-824-2143
  • Fax: 623-824-2143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW-21296
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-21296
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: