Provider Demographics
NPI:1639721277
Name:STEPPING STONES THERAPEUTIC SERVICES FOR CHILDREN AND ADULTS, PLLC
Entity Type:Organization
Organization Name:STEPPING STONES THERAPEUTIC SERVICES FOR CHILDREN AND ADULTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:H
Authorized Official - Last Name:SONG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:252-717-4373
Mailing Address - Street 1:2748 ANGE ST
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-7913
Mailing Address - Country:US
Mailing Address - Phone:252-717-4373
Mailing Address - Fax:252-751-0849
Practice Address - Street 1:3105 EVANS ST STE E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6899
Practice Address - Country:US
Practice Address - Phone:252-702-2298
Practice Address - Fax:252-751-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-14
Last Update Date:2019-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty