Provider Demographics
NPI:1043529662
Name:A STEP FORWARD L.L.C.
Entity Type:Organization
Organization Name:A STEP FORWARD L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:LELAND
Authorized Official - Middle Name:BOYD
Authorized Official - Last Name:KORB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-436-9304
Mailing Address - Street 1:P.O. BOX 1255
Mailing Address - Street 2:
Mailing Address - City:GLENROCK
Mailing Address - State:WY
Mailing Address - Zip Code:82637-1255
Mailing Address - Country:US
Mailing Address - Phone:307-436-8080
Mailing Address - Fax:
Practice Address - Street 1:506 WEST BIRCH
Practice Address - Street 2:SUITE 14
Practice Address - City:GLENROCK
Practice Address - State:WY
Practice Address - Zip Code:82637
Practice Address - Country:US
Practice Address - Phone:307-436-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLAT-291101YA0400X
WYLPC-391101YP2500X
103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty