Provider Demographics
NPI:1710272901
Name:NEXT STEP FEEDING AND BEHAVIORAL SERVICES
Entity Type:Organization
Organization Name:NEXT STEP FEEDING AND BEHAVIORAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:NISSA
Authorized Official - Middle Name:GOLDBERG
Authorized Official - Last Name:BATES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:505-507-7607
Mailing Address - Street 1:1284 DOWNING ST # 201
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2179
Mailing Address - Country:US
Mailing Address - Phone:505-507-7607
Mailing Address - Fax:
Practice Address - Street 1:1284 DOWNING ST # 201
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-2179
Practice Address - Country:US
Practice Address - Phone:505-507-7607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty