Healthcare Provider Details

I. General information

NPI: 1033738059
Provider Name (Legal Business Name): NEW STEPS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 04/09/2020
Certification Date: 04/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 JUNIPER RD
RUIDOSO NM
88345-6636
US

IV. Provider business mailing address

195 JUNIPER RD
RUIDOSO NM
88345-6636
US

V. Phone/Fax

Practice location:
  • Phone: 817-243-6468
  • Fax:
Mailing address:
  • Phone: 817-243-6468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASON L FERRELL
Title or Position: OWNER
Credential: MBA, LADAC, LCDC
Phone: 817-243-6468