Provider Demographics
NPI:1538633854
Name:STEP BY STEP MENTORING, LLC
Entity Type:Organization
Organization Name:STEP BY STEP MENTORING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:DURDEN
Authorized Official - Suffix:
Authorized Official - Credentials:BA, QMHP-A/C
Authorized Official - Phone:804-878-0318
Mailing Address - Street 1:3309 REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1431
Mailing Address - Country:US
Mailing Address - Phone:804-878-0318
Mailing Address - Fax:
Practice Address - Street 1:3309 REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-1431
Practice Address - Country:US
Practice Address - Phone:804-878-0318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-21
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health