Healthcare Provider Details

I. General information

NPI: 1467074591
Provider Name (Legal Business Name): NEXT STEP PSYCHOLOGICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 09/11/2022
Certification Date: 09/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

884 BRIGHTON RD
TONAWANDA NY
14150-8169
US

IV. Provider business mailing address

222 WYETH DR
GETZVILLE NY
14068-1260
US

V. Phone/Fax

Practice location:
  • Phone: 716-946-4804
  • Fax:
Mailing address:
  • Phone: 716-946-4804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JACQUELINE MARIE HARBRIDGE
Title or Position: NYS LICENSED PSYCHOLOGIST
Credential: PSY.D.
Phone: 716-946-4804