Healthcare Provider Details

I. General information

NPI: 1104720820
Provider Name (Legal Business Name): STEPPING STONES BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MCDANIEL ST
TYRONZA AR
72386-2007
US

IV. Provider business mailing address

121 MCDANIEL ST
TYRONZA AR
72386-2007
US

V. Phone/Fax

Practice location:
  • Phone: 402-612-4170
  • Fax:
Mailing address:
  • Phone: 402-612-4170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHRISTOPHER LYNN MARSHALL
Title or Position: EXECUTIVE ADMINISTRATOR
Credential:
Phone: 402-612-4170