Provider Demographics
NPI:1609934223
Name:STEPPING STONES INC
Entity Type:Organization
Organization Name:STEPPING STONES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:FRY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:304-429-2297
Mailing Address - Street 1:PO BOX 539
Mailing Address - Street 2:
Mailing Address - City:LAVALETTE
Mailing Address - State:WV
Mailing Address - Zip Code:25535-0539
Mailing Address - Country:US
Mailing Address - Phone:304-429-2297
Mailing Address - Fax:304-429-8365
Practice Address - Street 1:1235 BUFFALO CREEK ROAD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25704
Practice Address - Country:US
Practice Address - Phone:304-429-2297
Practice Address - Fax:304-429-8365
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0158542001Medicaid
WV0158542000Medicaid