Healthcare Provider Details

I. General information

NPI: 1992673883
Provider Name (Legal Business Name): FIRST STEP BEHAVIORAL HEALTH MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E NORTHERN PKWY STE 104
BALTIMORE MD
21239-2108
US

IV. Provider business mailing address

1900 E NORTHERN PKWY STE 104
BALTIMORE MD
21239-2108
US

V. Phone/Fax

Practice location:
  • Phone: 443-768-6132
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JEAN WATSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 443-768-6132