Healthcare Provider Details

I. General information

NPI: 1285351130
Provider Name (Legal Business Name): A STEP TO HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 INDEPENDENCE CT
SUFFOLK VA
23434-2369
US

IV. Provider business mailing address

116 INDEPENDENCE CT
SUFFOLK VA
23434-2369
US

V. Phone/Fax

Practice location:
  • Phone: 757-359-8144
  • Fax:
Mailing address:
  • Phone: 757-359-8144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CANDICE TANYA DOUGLAS
Title or Position: OWNER
Credential: LPC
Phone: 757-359-8144