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General NPI Number Information
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NPI Number | 1558891093
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Entity Type | Organization
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Legal Business Name | A STEP FORWARD COUNSELING LLC
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Dates
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Enumeration Date | 06/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 153 GREENWOOD AVE UNIT 5B
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City | BETHEL
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State | CT
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Zip | 06801-2559
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Country | US
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Telephone | 203-659-8877
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Fax |
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Provider Business Mailing Address
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Address Line | 153 GREENWOOD AVE UNIT 5B
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City | BETHEL
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State | CT
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Zip | 06801-2559
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Country | US
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Telephone | 203-659-8877
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | DANIEL CANIO PACE
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Credential |
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Telephone | 201-783-7001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 009321
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License Number State | CT
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