Provider Demographics
NPI:1962944843
Name:STEPSTO WELLNESS THERAPEUTIC SERVICES,LLC
Entity type:Organization
Organization Name:STEPSTO WELLNESS THERAPEUTIC SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:H
Authorized Official - Middle Name:DARRYL
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-789-7405
Mailing Address - Street 1:3227 NORTH ROLLING RD
Mailing Address - Street 2:2-C
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21244
Mailing Address - Country:US
Mailing Address - Phone:443-789-7405
Mailing Address - Fax:
Practice Address - Street 1:3227 NORTH ROLLING RD
Practice Address - Street 2:2-C
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21244
Practice Address - Country:US
Practice Address - Phone:443-789-7405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD045151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty