Provider Demographics
NPI:1063607158
Name:NEXTSTEP FAMILY COUNSELING
Entity type:Organization
Organization Name:NEXTSTEP FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AVA
Authorized Official - Middle Name:
Authorized Official - Last Name:LILLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-536-9310
Mailing Address - Street 1:9611 BROOKDALE DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-8719
Mailing Address - Country:US
Mailing Address - Phone:704-536-9310
Mailing Address - Fax:704-536-9311
Practice Address - Street 1:5500 EXECUTIVE CENTER DRIVE
Practice Address - Street 2:STE 202
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-5320
Practice Address - Country:US
Practice Address - Phone:704-536-9310
Practice Address - Fax:704-536-9311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health