Provider Demographics
NPI:1508454133
Name:A STEP BEYOND CLINICAL SERVICES LLC
Entity Type:Organization
Organization Name:A STEP BEYOND CLINICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON-CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, LSATP,
Authorized Official - Phone:757-260-9010
Mailing Address - Street 1:5007C VICTORY BLVD # 184
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23693-5601
Mailing Address - Country:US
Mailing Address - Phone:757-260-9010
Mailing Address - Fax:
Practice Address - Street 1:903 PRESTIGE CT
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-9437
Practice Address - Country:US
Practice Address - Phone:757-260-9010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health