Healthcare Provider Details

I. General information

NPI: 1003381880
Provider Name (Legal Business Name): MEGAN MARIE STEELE BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2018
Last Update Date: 10/28/2022
Certification Date: 10/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SE OCEAN BLVD STE 130D
STUART FL
34994-3503
US

IV. Provider business mailing address

1500 SE ROYAL GREEN CIR APT A102
PORT ST LUCIE FL
34952-7626
US

V. Phone/Fax

Practice location:
  • Phone: 772-219-7575
  • Fax: 855-457-4263
Mailing address:
  • Phone: 772-634-4852
  • Fax: 855-457-4263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number02011625
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number102003900
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: