Provider Demographics
NPI:1235628447
Name:STEPPING STONE FOUNDATION
Entity Type:Organization
Organization Name:STEPPING STONE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:LATIMER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:330-577-2285
Mailing Address - Street 1:240 S CHESTNUT ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-3026
Mailing Address - Country:US
Mailing Address - Phone:330-577-2285
Mailing Address - Fax:
Practice Address - Street 1:240 S CHESTNUT ST UNIT C
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3026
Practice Address - Country:US
Practice Address - Phone:330-577-2285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1800629261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0272903Medicaid