Healthcare Provider Details

I. General information

NPI: 1730796533
Provider Name (Legal Business Name): GOLDEN STEPS ABA MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2020
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6700 ALEXANDER BELL DR
COLUMBIA MD
21046-2122
US

IV. Provider business mailing address

600 3RD AVE FL 2
NEW YORK NY
10016-1919
US

V. Phone/Fax

Practice location:
  • Phone: 410-705-0227
  • Fax: 646-894-1116
Mailing address:
  • Phone: 646-873-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: REBECCA E ROSS
Title or Position: CREDENTIALING
Credential:
Phone: 615-570-9959