Basic Information
| Provider Information | |||||||||
| NPI: | 1861696700 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STEELE PSYCHIATRIC SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 120 FOX CHASE | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 290727990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8038088451 | ||||||||
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| Practice Location | |||||||||
| Address1: | 160 MEDICAL CIRCLE | ||||||||
| Address2: | 1ST FLOOR | ||||||||
| City: | WEST COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29169 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037966811 | ||||||||
| FaxNumber: | 8037966851 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2007 | ||||||||
| LastUpdateDate: | 07/20/2022 | ||||||||
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| AuthorizedOfficialLastName: | STEELE | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | CHARLES | ||||||||
| AuthorizedOfficialTitleorPosition: | PSYCHIATRIST | ||||||||
| AuthorizedOfficialTelephone: | 8038088451 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | II | ||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 07/20/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 25347 | SC | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 582296052001 | 01 | SC | PH RICHLAND BCBS GROUP | OTHER | 400186 | 05 | SC | MEDICAID |