Healthcare Provider Details

I. General information

NPI: 1114114071
Provider Name (Legal Business Name): FIRST STEP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 12/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 RIDGLAND RD SUITE 1
COCKEYSVILLE MD
21030-2715
US

IV. Provider business mailing address

10400 RIDGLAND RD SUITE 1
COCKEYSVILLE MD
21030-2715
US

V. Phone/Fax

Practice location:
  • Phone: 410-628-6120
  • Fax:
Mailing address:
  • Phone: 410-628-6120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateMD

VIII. Authorized Official

Name: MS. KIMBERLY BITTINGER
Title or Position: BUSINESS OPERATIONS MANAGER
Credential:
Phone: 410-628-6120