Provider Demographics
NPI:1417764481
Name:DR STEVE LLC SKILL TREE
Entity type:Organization
Organization Name:DR STEVE LLC SKILL TREE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:TASHA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DELLA VECCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-677-1639
Mailing Address - Street 1:4272 BUCKSKIN TRL
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-3102
Mailing Address - Country:US
Mailing Address - Phone:443-677-1639
Mailing Address - Fax:
Practice Address - Street 1:1216 N MAIN ST FRNT
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-2256
Practice Address - Country:US
Practice Address - Phone:443-900-3999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty