Provider Demographics
NPI:1750743076
Name:FIRST STEP RECOVERY COUNSELING SERVICES
Entity type:Organization
Organization Name:FIRST STEP RECOVERY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LINETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LESLIE-FONDON
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, LPC, CACII
Authorized Official - Phone:706-593-0827
Mailing Address - Street 1:3575 MACON RD
Mailing Address - Street 2:SUITE # 12
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-8200
Mailing Address - Country:US
Mailing Address - Phone:706-221-4860
Mailing Address - Fax:706-221-4870
Practice Address - Street 1:3575 MACON RD
Practice Address - Street 2:SUITE # 12
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-8200
Practice Address - Country:US
Practice Address - Phone:706-221-4860
Practice Address - Fax:706-221-4870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-25
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003879251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health