Healthcare Provider Details

I. General information

NPI: 1184809808
Provider Name (Legal Business Name): STEP BY STEP CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2007
Last Update Date: 10/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 E MARKET ST SUITE 100 B
GREENSBORO NC
27401-3265
US

IV. Provider business mailing address

709 E MARKET ST SUITE 100 B
GREENSBORO NC
27401-3265
US

V. Phone/Fax

Practice location:
  • Phone: 336-378-0109
  • Fax: 336-378-0180
Mailing address:
  • Phone: 336-378-0109
  • Fax: 336-378-0180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. JAVONDELL RISOTTO STALLINGS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 336-378-0109