MEDICARE: STEPPING STONES INC

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	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609934223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPPING STONES INC

Provider Business Mailing Address
First Line	:	PO BOX 539
Second Line	:
City	:	LAVALETTE
State	:	WV
Zip	:	25535-0539
Country	:	US
Telephone Number	:	304-429-2297
Fax Number	:	304-429-8365

Provider Business Practice Location Address
First Line	:	1235 BUFFALO CREEK ROAD
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25704
Country	:	US
Telephone Number	:	304-429-2297
Fax Number	:	304-429-8365

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. SUSAN R FRY
Credential	:	LPC
Telephone Number	:	304-429-2297

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	08/22/2020

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Directions to “STEPPING STONES INC ” Practice Location

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