Provider Demographics
NPI:1619416575
Name:NEXT STEP COUNSELING, LLC
Entity Type:Organization
Organization Name:NEXT STEP COUNSELING, LLC
Other - Org Name:NEXT STEP COUNSELING & ASSESSMENTS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEISHA
Authorized Official - Middle Name:LATONYA
Authorized Official - Last Name:POU
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:770-371-5057
Mailing Address - Street 1:110 HABERSHAM DR
Mailing Address - Street 2:SUITE 142
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-1381
Mailing Address - Country:US
Mailing Address - Phone:770-371-5057
Mailing Address - Fax:
Practice Address - Street 1:110 HABERSHAM DR
Practice Address - Street 2:SUITE 142
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-1381
Practice Address - Country:US
Practice Address - Phone:770-371-5057
Practice Address - Fax:404-537-1045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5425251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1962671131OtherNPI
GA384025512AMedicaid