=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407652878
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PEACEFUL STEPS COUNSELING CENTER PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/24/2025
-----------------------------------------------------
Last Update Date | 02/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 135 MICAH LN
-----------------------------------------------------
City | IRON STATION
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28080-6709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 980-223-9740
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 135 MICAH LN
-----------------------------------------------------
City | IRON STATION
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28080-6709
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL MENTAL HEALTH COUNSELOR
-----------------------------------------------------
Name | MR. GABRIEL FRANCISCO RUEDA
-----------------------------------------------------
Credential | LCMHC
-----------------------------------------------------
Telephone | 980-223-9740
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------