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General NPI Number Information
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NPI Number | 1407311202
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Entity Type | Organization
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Legal Business Name | STEPPING STONE COMMUNITY SERVICES, LLC
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 223 W MAIN ST
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City | RAVENNA
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State | OH
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Zip | 44266-2741
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Country | US
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Telephone | 330-577-4099
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Fax | 844-274-3002
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Provider Business Mailing Address
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Address Line | 223 W MAIN ST
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City | RAVENNA
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State | OH
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Zip | 44266-2741
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Country | US
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Telephone | 330-577-4099
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Fax | 844-274-3002
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Authorized Official
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Title or Position | OWNER
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Name | BETHANY T LATIMER
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Credential | LPCC-S
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Telephone | 330-577-6656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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