Provider Demographics
NPI:1912560616
Name:STEP-BY-STEP BEHAVIORAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:STEP-BY-STEP BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:CORLEY
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:888-763-7837
Mailing Address - Street 1:PO BOX 26142
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32226-6142
Mailing Address - Country:US
Mailing Address - Phone:888-763-7837
Mailing Address - Fax:888-376-7135
Practice Address - Street 1:1760 SHADOWOOD LN STE 408
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-2182
Practice Address - Country:US
Practice Address - Phone:888-763-7837
Practice Address - Fax:888-376-7135
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEP-BY-STEP BEHAVIORAL HEALTH SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-17
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021961002Medicaid