Provider Demographics
NPI:1003150947
Name:STEPPING STONE BEHAVORIAL HEALTH CLINIC, LLC
Entity Type:Organization
Organization Name:STEPPING STONE BEHAVORIAL HEALTH CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:262-951-6969
Mailing Address - Street 1:7441 W GREENFIELD AVE
Mailing Address - Street 2:SUITE 15
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53214-4676
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7441 W GREENFIELD AVE
Practice Address - Street 2:SUITE 15
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53214-4676
Practice Address - Country:US
Practice Address - Phone:262-951-6969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3797-125261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)