MEDICARE: KELLY STEEL MSW, LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I.1600680	OH

General Provider Information

NPI Number	:	1548669468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY STEEL MSW, LSW

Provider Business Mailing Address
First Line	:	3433 AGLER RD STE 2800
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-3389
Country	:	US
Telephone Number	:	614-645-1600
Fax Number	:	614-645-1347

Provider Business Practice Location Address
First Line	:	3433 AGLER RD STE 2800
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-3389
Country	:	US
Telephone Number	:	614-645-1600
Fax Number	:	614-645-1347

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2014
Last Update Date	:	10/30/2017

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