Provider Demographics
NPI:1477100048
Name:A STEP FORWARD, LLC
Entity Type:Organization
Organization Name:A STEP FORWARD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGICAL PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:LPP
Authorized Official - Phone:606-226-5295
Mailing Address - Street 1:8255 KY ROUTE 122
Mailing Address - Street 2:
Mailing Address - City:MINNIE
Mailing Address - State:KY
Mailing Address - Zip Code:41651-9008
Mailing Address - Country:US
Mailing Address - Phone:606-226-5295
Mailing Address - Fax:
Practice Address - Street 1:8255 KY ROUTE 122
Practice Address - Street 2:
Practice Address - City:MINNIE
Practice Address - State:KY
Practice Address - Zip Code:41651-9008
Practice Address - Country:US
Practice Address - Phone:606-226-5295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency