Provider Demographics
NPI:1205112430
Name:STEPS FOR CHANGE BEHAVIORAL HEALTH CARE AND COUNSELING CENTER
Entity type:Organization
Organization Name:STEPS FOR CHANGE BEHAVIORAL HEALTH CARE AND COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-302-0801
Mailing Address - Street 1:103 S BRADY ST
Mailing Address - Street 2:
Mailing Address - City:RAMSEUR
Mailing Address - State:NC
Mailing Address - Zip Code:27316-9538
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:103 S BRADY ST
Practice Address - Street 2:
Practice Address - City:RAMSEUR
Practice Address - State:NC
Practice Address - Zip Code:27316-9538
Practice Address - Country:US
Practice Address - Phone:336-824-1735
Practice Address - Fax:888-321-3812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC076-104Medicaid