Healthcare Provider Details

I. General information

NPI: 1720768112
Provider Name (Legal Business Name): DELICATE STEPS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 07/21/2024
Certification Date: 07/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

591 SW SADWICK AVE
PORT ST LUCIE FL
34953-3867
US

IV. Provider business mailing address

591 SW SADWICK AVE
PORT ST LUCIE FL
34953-3867
US

V. Phone/Fax

Practice location:
  • Phone: 772-212-8900
  • Fax: 772-291-9422
Mailing address:
  • Phone: 772-212-8900
  • Fax: 772-291-9422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOANN RIVERA DECICCO
Title or Position: CEO
Credential:
Phone: 772-212-8900