MEDICARE: THE RIGHT STEP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0093481	NM

General Provider Information

NPI Number	:	1518080944
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE RIGHT STEP

Provider Business Mailing Address
First Line	:	PO BOX 23912
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87502-3912
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	460 SAINT MICHAELS DR
Second Line	:	SUITE 806
City	:	SANTA FE
State	:	NM
Zip	:	87505-7619
Country	:	US
Telephone Number	:	505-989-1470
Fax Number	:

Authorized Official
Title or Position	:	CORP DIR OF CONTRACT MGMT
Name	:	JOHN GERVASI III
Credential	:
Telephone Number	:	505-550-9182

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	08/22/2020

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Directions to “THE RIGHT STEP ” Practice Location

Language	Start Address	Practice Location

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