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General NPI Number Information
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NPI Number | 1003150947
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Entity Type | Organization
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Legal Business Name | STEPPING STONE BEHAVORIAL HEALTH CLINIC, LLC
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Dates
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Enumeration Date | 11/15/2012
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Last Update Date | 11/15/2012
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Provider Practice Location Address
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Address Line | 7441 W GREENFIELD AVE SUITE 15
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City | MILWAUKEE
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State | WI
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Zip | 53214-4676
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Country | US
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Telephone | 262-951-6969
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Fax |
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Provider Business Mailing Address
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Address Line | 7441 W GREENFIELD AVE SUITE 15
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City | MILWAUKEE
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State | WI
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Zip | 53214-4676
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEBRA PIERSON
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Credential | LPC
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Telephone | 262-951-6969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 3797-125
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License Number State | WI
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