Healthcare Provider Details

I. General information

NPI: 1114910213
Provider Name (Legal Business Name): CAROL STEELE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAROL STEELE LEMAY PH.D.

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 10/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 E. BROADWAY BLVD. STE. 203
JEFFERSON CITY TN
37760-2837
US

IV. Provider business mailing address

222 E. BROADWAY BLVD STE. 203
JEFFERSON CITY TN
37760-2837
US

V. Phone/Fax

Practice location:
  • Phone: 865-475-9199
  • Fax: 865-475-9193
Mailing address:
  • Phone: 865-475-9199
  • Fax: 865-475-9193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberP1820
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: