Healthcare Provider Details

I. General information

NPI: 1003271545
Provider Name (Legal Business Name): STEPPING STONES TREATMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 12/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8132 TUMBLEWEED TRL
FT WORTH TX
76108-3519
US

IV. Provider business mailing address

8132 TUMBLEWEED TRL
FT WORTH TX
76108-3519
US

V. Phone/Fax

Practice location:
  • Phone: 682-554-5802
  • Fax:
Mailing address:
  • Phone: 682-554-5802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number72379
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number72379
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number72379
License Number StateTX

VIII. Authorized Official

Name: DR. LAURIE BREWER DOWNEY
Title or Position: THERAPIST, COUNSELOR
Credential: PHD
Phone: 682-554-5802