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General NPI Number Information
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NPI Number | 1073012555
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Entity Type | Organization
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Legal Business Name | PIVOTAL STEP SERVICES, PLLC
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Dates
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Enumeration Date | 02/09/2018
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Last Update Date | 02/09/2018
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Provider Practice Location Address
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Address Line | 1106B GUM BRANCH RD
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City | JACKSONVILLE
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State | NC
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Zip | 28540-5743
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Country | US
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Telephone | 910-370-1333
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Fax | 910-356-9163
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Provider Business Mailing Address
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Address Line | 140 BALSAM RD
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City | JACKSONVILLE
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State | NC
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Zip | 28546-8508
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Country | US
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Telephone | 910-370-1333
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Fax | 910-356-9163
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Authorized Official
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Title or Position | OWNER
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Name | RONALD L DINGLE
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Credential | LPC, LCAS
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Telephone | 910-370-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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