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NPI Code Detail

MEDICARE: SHINING STEPS ABA OF NORTH CAROLINA LLC

MEDICARE: SHINING STEPS ABA OF NORTH CAROLINA LLC
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1922950252
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHINING STEPS ABA OF NORTH CAROLINA LLC
Provider Business Mailing Address
First Line : 2941 W FARGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60645-1222
Country : US
Telephone Number : 872-203-3994
Fax Number :
Provider Business Practice Location Address
First Line : 4030 WAKE FOREST RD STE 349
Second Line :
City : RALEIGH
State : NC
Zip : 27609-0010
Country : US
Telephone Number : 872-203-3994
Fax Number :
Authorized Official
Title or Position : CFO
Name : ASHER STEIN
Credential :
Telephone Number : 872-203-3994
Provider Enumeration Date : 02/10/2026
Last Update Date : 02/10/2026

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