Healthcare Provider Details

I. General information

NPI: 1487803227
Provider Name (Legal Business Name): STEPPING STONE FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 RESEARCH DR SUITE 102
CHESAPEAKE VA
23320-5984
US

IV. Provider business mailing address

212 RESEARCH DR SUITE 102
CHESAPEAKE VA
23320-5984
US

V. Phone/Fax

Practice location:
  • Phone: 757-673-8117
  • Fax: 757-673-8127
Mailing address:
  • Phone: 757-673-8117
  • Fax: 757-673-8127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: TAQUISA KATINA SIMMONS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LCSW,CSAC,CSOTP
Phone: 757-673-8117