Healthcare Provider Details

I. General information

NPI: 1073701603
Provider Name (Legal Business Name): RENAN STEELE LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 07/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 45TH ST
WEST PALM BEACH FL
33407-2402
US

IV. Provider business mailing address

1041 45TH ST
WEST PALM BEACH FL
33407-2402
US

V. Phone/Fax

Practice location:
  • Phone: 561-383-8000
  • Fax: 561-514-1275
Mailing address:
  • Phone: 561-383-8000
  • Fax: 561-514-1275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH5176
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH10021
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberIMH5176
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH10021
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: