Provider Demographics
NPI:1336253509
Name:STEPPING STONES PEDIATRIC SERVICES, INC.
Entity Type:Organization
Organization Name:STEPPING STONES PEDIATRIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:828-686-4452
Mailing Address - Street 1:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-0880
Mailing Address - Country:US
Mailing Address - Phone:828-686-4452
Mailing Address - Fax:828-686-4452
Practice Address - Street 1:130 EAGLE'S REACH DRIVE
Practice Address - Street 2:BLUE RIDGE COMMUNITY COLLEGE
Practice Address - City:FLAT ROCK
Practice Address - State:NC
Practice Address - Zip Code:28731-4728
Practice Address - Country:US
Practice Address - Phone:828-692-7068
Practice Address - Fax:828-696-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7920225100000X
NC1376225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC079U2OtherBCBSNC PROVIDER
NC7211366Medicaid