Healthcare Provider Details

I. General information

NPI: 1720923758
Provider Name (Legal Business Name): KIMBERLY STEELE BSW
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 W CENTRE AVE
PORTAGE MI
49024-4819
US

IV. Provider business mailing address

4341 S WESTNEDGE AVE STE 1112
KALAMAZOO MI
49008-3283
US

V. Phone/Fax

Practice location:
  • Phone: 269-257-9060
  • Fax:
Mailing address:
  • Phone: 269-615-7637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: