Healthcare Provider Details

I. General information

NPI: 1952256927
Provider Name (Legal Business Name): BIGSTEP ARIZONA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3707 E SOUTHERN AVE STE 1099
MESA AZ
85206-6209
US

IV. Provider business mailing address

3707 E SOUTHERN AVE STE 1099
MESA AZ
85206-6209
US

V. Phone/Fax

Practice location:
  • Phone: 800-402-0941
  • Fax:
Mailing address:
  • Phone: 800-402-0941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. KENEAPHA RENEE PATTON
Title or Position: PROGRAM DIRECTOR
Credential: PRSS
Phone: 800-402-0941