Healthcare Provider Details

I. General information

NPI: 1831549633
Provider Name (Legal Business Name): ONE STEP FORWARD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2016
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 WOODY RIDGE RD
CHARLOTTE NC
28273-5777
US

IV. Provider business mailing address

10000 WOODY RIDGE RD
CHARLOTTE NC
28273-5777
US

V. Phone/Fax

Practice location:
  • Phone: 704-523-4299
  • Fax:
Mailing address:
  • Phone: 704-523-4299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MARSHA DAYMON
Title or Position: OWNER
Credential:
Phone: 704-496-1186