MEDICARE: MRS. JENNY CALDWELL STEINDAM M.DIV.,P.C.C.

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	101Y00000X	Counselor	E3090	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000315459	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1760579007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNY CALDWELL STEINDAM M.DIV.,P.C.C.

Provider Business Mailing Address
First Line	:	6230 BUSCH BLVD
Second Line	:	SUITE 310
City	:	COLUMBUS
State	:	OH
Zip	:	43229-1826
Country	:	US
Telephone Number	:	614-885-2431
Fax Number	:	614-885-6188

Provider Business Practice Location Address
First Line	:	6230 BUSCH BLVD
Second Line	:	SUITE 310
City	:	COLUMBUS
State	:	OH
Zip	:	43229-1826
Country	:	US
Telephone Number	:	614-885-2431
Fax Number	:	614-885-6188

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	07/08/2007

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