Provider Demographics
NPI:1124014253
Name:STEPPING STONES PEDIATRIC THERAPY, LLC
Entity Type:Organization
Organization Name:STEPPING STONES PEDIATRIC THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-626-4142
Mailing Address - Street 1:1505 N ALMA SCHOOL RD
Mailing Address - Street 2:STE 2
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2900
Mailing Address - Country:US
Mailing Address - Phone:480-626-4142
Mailing Address - Fax:480-626-7370
Practice Address - Street 1:1505 N ALMA SCHOOL RD
Practice Address - Street 2:STE 2
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2900
Practice Address - Country:US
Practice Address - Phone:480-626-4142
Practice Address - Fax:480-626-7370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ58992251P0200X
AZ3031225XP0200X
AZSLP1902235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ893025Medicaid
AZAZ0463880OtherBCBS ID NUMBER