Healthcare Provider Details

I. General information

NPI: 1326519794
Provider Name (Legal Business Name): NEXT STEP FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2018
Last Update Date: 12/20/2022
Certification Date: 12/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 WASHINGTON AVE
TERRE HAUTE IN
47802-1128
US

IV. Provider business mailing address

619 WASHINGTON AVE
TERRE HAUTE IN
47802-1128
US

V. Phone/Fax

Practice location:
  • Phone: 812-917-5006
  • Fax: 812-645-1303
Mailing address:
  • Phone: 812-917-5006
  • Fax: 812-645-1303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DANA ELIZABETH SIMONS
Title or Position: EXECUTIVE DIRECTOR
Credential: LCSW, LCAC
Phone: 812-917-5006