Provider Demographics
NPI:1447776992
Name:LITTLE STEPS SPEECH AND LANGUAGE STUDIO LLC
Entity Type:Organization
Organization Name:LITTLE STEPS SPEECH AND LANGUAGE STUDIO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:POPKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:646-591-1664
Mailing Address - Street 1:1650 OCEAN PKWY APT 5H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2153
Mailing Address - Country:US
Mailing Address - Phone:646-591-1664
Mailing Address - Fax:
Practice Address - Street 1:1650 OCEAN PKWY APT 5H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2153
Practice Address - Country:US
Practice Address - Phone:646-591-1664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03842220Medicaid