Provider Demographics
NPI:1508263039
Name:STEPPING STONES COUNSELING LLC
Entity Type:Organization
Organization Name:STEPPING STONES COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:KACK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW, LADC
Authorized Official - Phone:507-530-3852
Mailing Address - Street 1:800 E ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:BELLE PLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:56011-2182
Mailing Address - Country:US
Mailing Address - Phone:507-530-3852
Mailing Address - Fax:
Practice Address - Street 1:8170 OLD CARRIAGE CT
Practice Address - Street 2:SUITE 200
Practice Address - City:SHAKOPEE
Practice Address - State:MN
Practice Address - Zip Code:55379-3163
Practice Address - Country:US
Practice Address - Phone:507-530-3852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN302218101YA0400X
101YP2500X, 106H00000X
MN167421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty