Provider Demographics
NPI:1639782881
Name:GOLDEN STEPS ABA NC LLC
Entity Type:Organization
Organization Name:GOLDEN STEPS ABA NC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:YISROEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLMARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-596-5130
Mailing Address - Street 1:600 3RD AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-1919
Mailing Address - Country:US
Mailing Address - Phone:646-873-6600
Mailing Address - Fax:
Practice Address - Street 1:19109 W CATAWBA AVE
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5611
Practice Address - Country:US
Practice Address - Phone:845-596-5130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-27
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health