Provider Demographics
NPI:1851067169
Name:STEP-BY-STEP BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:STEP-BY-STEP BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:CORLEY
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:904-408-9288
Mailing Address - Street 1:PO BOX 26142
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32226-6142
Mailing Address - Country:US
Mailing Address - Phone:904-408-9288
Mailing Address - Fax:888-376-7135
Practice Address - Street 1:1760 SHADOWOOD LN STE 408
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-2182
Practice Address - Country:US
Practice Address - Phone:888-763-7837
Practice Address - Fax:888-376-7135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024744400Medicaid