Provider Demographics
NPI:1609460880
Name:POSITIVE STEPS CONSULTING AND PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:POSITIVE STEPS CONSULTING AND PSYCHOLOGICAL SERVICES LLC
Other - Org Name:POSTIVE STEPS COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OTIMBUM
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPCC
Authorized Official - Phone:216-399-3130
Mailing Address - Street 1:1924 REVERE RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2234
Mailing Address - Country:US
Mailing Address - Phone:952-807-6093
Mailing Address - Fax:
Practice Address - Street 1:5 SEVERANCE CIR STE 802
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1592
Practice Address - Country:US
Practice Address - Phone:216-399-3130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-27
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health