MEDICARE: FIRST STEP CARE GROUP LLC

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

General Provider Information

NPI Number	:	1194642710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST STEP CARE GROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 464
Second Line	:
City	:	PLYMOUTH
State	:	FL
Zip	:	32768-0464
Country	:	US
Telephone Number	:	407-470-5908
Fax Number	:

Provider Business Practice Location Address
First Line	:	9401 W COLONIAL DR STE 726
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-6811
Country	:	US
Telephone Number	:	689-308-3232
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SLYVING BOURDEAU
Credential	:	LCSW
Telephone Number	:	407-470-5908

Provider Enumeration Date	:	07/03/2026
Last Update Date	:	07/03/2026

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