Healthcare Provider Details

I. General information

NPI: 1851642151
Provider Name (Legal Business Name): FIRST STEPS COUNSELING OF ALLIANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2012
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1652 S UNION AVE
ALLIANCE OH
44601-4349
US

IV. Provider business mailing address

1652 S UNION AVE
ALLIANCE OH
44601-4349
US

V. Phone/Fax

Practice location:
  • Phone: 330-754-3705
  • Fax: 330-754-3706
Mailing address:
  • Phone: 330-754-3705
  • Fax: 330-754-3706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE1000016
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number1100002
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM0700002
License Number StateOH

VIII. Authorized Official

Name: MRS. SHANNON ORTIZ
Title or Position: OWNER
Credential: PCC, MFT
Phone: 330-631-3554